Full Name Phone Number Example: xxx-xxx-xx-xx-xx Email City Please select an Amideast office location for your placement test - Select -RamallahNablusHebronJerusalem Please select the English language program that you are interested in - Select -Adults ( Ages 17 and above)Teens ( Ages 12-16)Young Leaner’s (Ages 6-11) Are you a new student? Yes No Where did you first hear about Amideast’s courses? Social Media Work School/University Family/Friends Amideast Website What are your main reasons for taking this course? What are your main reasons for taking this course? Improve general English skills Prepare for an exam (TOEFL, IELTS, etc.) Enhance professional skills (business, workplace communication, etc.) Improve academic English Other Other: Have you previously taken an amideast Course ? Have you previously taken an amideast Course ? NO YES If yes, when? Specifiy CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.