Language Training Request Form

Upon completion of below information, please place a MyServices request to “Human Resources / HR (LE
Staff) Request / Miscellaneous HR Request (LE Staff)” for further action.

Employee Information
Full Name: Position Title: Esposa

Diana Vanessa Cordova Sandoval(Prado)

Agency / Section:
Work Email: vprado1712@gmail.com Office Phone:

Personal Email: diana.cordova@cip.org.pe Cell phone: +519511737182

Alejandro Prado
______________________________________________________________________________________________
Name American Supervisor Signature
Class Information
Start Date: Instructor Name:

Select your current Rudimentary Knowledge Limited Knowledge Good working knowledge Fluent
English level (Level 1) (Level 2) (Level 3) (Level 4)
Preferred Class Time 7:00 – 8:30 11:00 – 12:30 12:30 – 2:00 4:00 – 5:30
(Monday to Friday) 4:00 – 6:00 5:00 – 7:00 *Other
Preferred Class Time
7:00 – 11:00 7:00 – 10:00 10:00 – 1:00 10:00 – 2:00
(Saturday)

Course Objectives:
Through this course I intend to obtain: English level:

Speaking Level: One Two Three Four Other skills

Listening Level: One Two Three Four Other skills
Reading Level: One Two Three Four Other skills
Writing Level: One Two Three Four Other skills
Comments:

Avanti’s Language Coordinator will contact you via email to coordinate the placement test and schedule the
English classes.

www.avantilanguageschool.com, Carrera 21 No. 87-24 PBX. (571)6346637 (57) 311 233 71 61 BOGOTA D.C. COLOMBIA

SENSITIVE BUT UNCLASSIFIED