PENOBSCOT SCHOOL
28 Gay Street, Rockland, Maine 04841
Tel.: 207 594-1084 Fax: 207 594-1067
penobscot@languagelearning.org

ENGLISH COURSE APPLICATION
Your name:   Sex:    M    F
Mailing address:  
   
City: Country:
Tel number: (day)   (evening)  
fax number:  
e-mail:    
Date of Birth:   Place of Birth  
Your native language and other languages you speak:  
Your profession or occupation:  
Your history of English study and your level of English ability:  
When do you want to attend Penobscot School?  
How did you hear about Penobscot School?  
Do you have any dietary restrictions, allergies, or food preferences?  

Print this form, fill it in, and mail or fax it to us. Or you may fill out our online form by clicking here.

Please do not include any money with your application. We will notify you as soon as possible about whether we have a place for you. If you are accepted, we will ask you to send a deposit of $300 to reserve your place.