On-line enrolment for courses at Margate Language Centre

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Margate Language Centre on-line enrolment

PERSONAL INFORMATION

Your first name:

Your family name:

Your sex:

Your address:

Your town/city:

Your postal code:

The country where you live:

Your telephone number:

Your e-mail address:

Do you suffer from any illnesses or disabilities:

If yes, please give full details:

Your nationality:

Your first language:

Your date of birth:

Your job (if student, which subject are you studying):

Your hobbies and interests:

YOUR LEVEL OF ENGLISH

Please estimate your level of English:

How many years have you been studying English?

COURSE DETAILS

Course start date:

Course end date:

Which course would you like to do?

Please select any supplements you would like to add to your course:

Individual Classes

How many per week?

TOEIC test

Working Lunch

How many during your stay?

ARRIVAL AND DEPARTURE INFORMATION

How do you intend to travel to Margate?

Your date of arrival:

Would you like a taxi to meet you on your arrival in England?

Your point of arrival and travel details (if you know them):

Your date of departure:

Would you like a taxi for your departure?

Your point of departure and travel details (if you know them):

ACCOMMODATION

Would you like us to arrange homestay accommodation?

If yes, for how many weeks?

Homestay start date:

Homestay end date:

Do you smoke?

Do you require a non-smoking family?

Do you have any special dietary requirements e.g. vegetarian:

Do you have any allergies e.g. cats, dust:

I have read and accepted the

of enrolment with Margate Language Centre

PLEASE NOTE: As soon as we have received this booking we will contact you with details on your payment and how it can be made. Your booking will not be complete until the necessary payment has been made.