Application Form



righttopApplication FormAdult CoursesPersonal INFORMATIONPlease provide first name and surname as they appear on your passport.Title: FORMCHECKBOX Mr FORMCHECKBOX Ms FORMCHECKBOX Miss FORMCHECKBOX Mrs FORMCHECKBOX Dr FORMCHECKBOX Other (please specify): FORMTEXT ?????First name: FORMTEXT ?????Surname: FORMTEXT ?????Gender: FORMCHECKBOX Male FORMCHECKBOX FemaleDate of birth: (DD/MM/YY) FORMTEXT ?????Nationality: FORMTEXT ?????First language: FORMTEXT ?????Your level of English: FORMCHECKBOX Breakthrough (A1) FORMCHECKBOX Elementary (A2) FORMCHECKBOX Pre-Intermediate (A2/B1) FORMCHECKBOX Intermediate (B1) FORMCHECKBOX Upper-Intermediate (B2) FORMCHECKBOX Advanced (C1)Passport number: FORMTEXT ?????Expiry date: (DD/MM/YY) FORMTEXT ?????Country of issue: FORMTEXT ?????Address: FORMTEXT ?????Telephone: FORMTEXT ?????Email: FORMTEXT ?????Skype: FORMTEXT ????? FORMCHECKBOX Please tick this box if you don't want to receive occasional email newsletters and promotions from us.How did you hear about us? FORMTEXT ?????Emergency Contact DETAILSFirst name: FORMTEXT ?????Surname: FORMTEXT ?????Their relationship to you: FORMTEXT ?????What languages do they speak? FORMTEXT ?????Telephone: FORMTEXT ?????Email: FORMTEXT ?????DISABILITIESIf you have a disability or specific learning difficulty that might affect your studies, it is important that you tell us prior to arrival.Do you have a disability? FORMCHECKBOX No FORMCHECKBOX Yes (please provide details): FORMTEXT ?????Can you suggest ways in which we can help? FORMTEXT ?????Medical ConditionsDo you have any allergies? FORMCHECKBOX No FORMCHECKBOX Yes (please provide details): FORMTEXT ?????Are you taking any medication? FORMCHECKBOX No FORMCHECKBOX Yes (please provide details): FORMTEXT ?????SPONSORSHIPIt is important we know if your fees are being funded by a sponsor, for example, an embassy or private company.Are you a sponsored student? FORMCHECKBOX No FORMCHECKBOX YesName of the sponsor: FORMTEXT ?????Please provide details: FORMTEXT ?????VISA DETAILSComplete this section only if you are required to obtain a visa to study in the UK. Please enclose a copy of your passport.Type of visa you wish to apply for: FORMCHECKBOX Short-Term Study Visa (please complete the Visa Extension section below) FORMCHECKBOX Tier 4 (General) FORMCHECKBOX Child Visitor Visa FORMCHECKBOX Electronic Visa Waiver (Kuwait, Oman, Qatar, United Arab Emirates)short-term study visa extensionPlease note that due to a new appendix to the Short-Term Study Visa regulations, students are only able to extend their stay in the UK by 30 days beyond the end of their course end date unless it is specified at visa application stage that you intend to do so.Do you intend to extend your course beyond the mentioned end date? FORMCHECKBOX No FORMCHECKBOX YesEXPRESS MAIL (FOR SHORT-TERM STUDY VISA) FORMCHECKBOX Please tick this box if you wish to receive the original course confirmation documents by express mail for an additional fee of ?20. Please specify the contact name, telephone number and delivery address, if different from those provided above.Contact name: FORMTEXT ?????Telephone: FORMTEXT ?????Address: FORMTEXT ?????CourseStart date: (DD/MM/YY) FORMTEXT ?????Duration (weeks): FORMTEXT ?????CourseLondon CentralLondon HampsteadOxfordBrightonManchesterYorkEdinburghDublinGeneral EnglishG15AM FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G20 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G30 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G15PM- FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX -G20PM--- FORMCHECKBOX ----Study Semester / YearSY20 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX SY25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX SY30 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX General English Plus Business English1B25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX --- FORMCHECKBOX B30 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX --- FORMCHECKBOX IELTS Preparation2IE20 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX - FORMCHECKBOX -IE25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX - FORMCHECKBOX -IE30 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX - FORMCHECKBOX -General English Plus IELTS Preparation2IE20----- FORMCHECKBOX - FORMCHECKBOX IE25----- FORMCHECKBOX - FORMCHECKBOX IE30----- FORMCHECKBOX - FORMCHECKBOX General English Plus One-to-One TOEIC or TOEFL Preparation1TOEFL22 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX TOEIC22 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX CourseLondon CentralLondon HampsteadOxfordBrightonManchesterYorkEdinburghDublinGeneral English Plus TOEIC or TOEFL Summer Preparation in Mini-Groups1TOEFL25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX -----TOEIC25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX -----Cambridge Exam Preparation2FCE25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX CAE25 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Other CoursesEnglish Plus Internship FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX English Plus Cookery1,3 FORMCHECKBOX -------English Plus Windsurfing1--- FORMCHECKBOX ----English Plus Wakeboarding1--- FORMCHECKBOX ----English for 50+1----- FORMCHECKBOX FORMCHECKBOX -English at the Edinburgh Festivals1------ FORMCHECKBOX -Private Lessons FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 1 Minimum entry level: Intermediate. 2 Subject to pre-test results, please request a pre-test from a member of Student Services before applying. 3 Minimum age: 18 years.ONLINE LESSONSYou can add extra live online lessons with a UK-based teacher before or after your course in the UK.General English FORMCHECKBOX Standard General English FORMCHECKBOX Pronunciation Skills FORMCHECKBOX Grammar & Writing Skills FORMCHECKBOX Conversation Skills Business English FORMCHECKBOX Standard General English FORMCHECKBOX Business Writing Skills FORMCHECKBOX Socialising & Networking Skills FORMCHECKBOX Meetings & Negotiations Skills FORMCHECKBOX Presentation Skills FORMCHECKBOX Get That JobExam Preparation FORMCHECKBOX IELTS FORMCHECKBOX Cambridge FCE FORMCHECKBOX Cambridge CAE FORMCHECKBOX TOEIC FORMCHECKBOX TOEFL FORMCHECKBOX OETWhen FORMCHECKBOX Pre-arrival FORMCHECKBOX Post-departureGroup size FORMCHECKBOX Max. 4 students FORMCHECKBOX PrivateNumber of lessons FORMCHECKBOX 5 lessons FORMCHECKBOX 20 lessons FORMCHECKBOX 10 lessons FORMCHECKBOX 30 lessonsAccommodationDo you require accommodation? FORMCHECKBOX No FORMCHECKBOX Yes (please provide your arrival details in the next section even if you don’t require a transfer)Start date: (DD/MM/YY) FORMTEXT ?????End date: (DD/MM/YY) FORMTEXT ?????AccommodationLondon CentralLondon HampsteadOxfordBrightonManchesterYorkEdinburghDublinStandard HomestaySingle room, full board--- FORMCHECKBOX ----Single room, half board FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Single room, breakfast only FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX -- FORMCHECKBOX FORMCHECKBOX Single room, self-catering FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX ----Shared room,full board--- FORMCHECKBOX Double FORMCHECKBOX Twin----Shared room, half board FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin- FORMCHECKBOX Double FORMCHECKBOX Twin-Shared room, breakfast only FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin-- FORMCHECKBOX Double FORMCHECKBOX Twin-Shared room, self-catering--- FORMCHECKBOX Double FORMCHECKBOX Twin----AccommodationLondon CentralLondon HampsteadOxfordBrightonManchesterYorkEdinburghDublinExecutive HomestaySingle room, half board FORMCHECKBOX FORMCHECKBOX - FORMCHECKBOX - FORMCHECKBOX --Single room, breakfast only FORMCHECKBOX FORMCHECKBOX - FORMCHECKBOX ----Standard Student HouseSingle room, self-catering FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Standard FORMCHECKBOX Budget FORMCHECKBOX -- FORMCHECKBOX Single room, en-suite, self-catering-- FORMCHECKBOX 66 FORMCHECKBOX 101- FORMCHECKBOX ---Shared room, self-catering FORMCHECKBOX Double FORMCHECKBOX Twin FORMCHECKBOX Double FORMCHECKBOX Twin-- FORMCHECKBOX Double FORMCHECKBOX Twin---Shared room, en-suite, self-catering---- FORMCHECKBOX Double FORMCHECKBOX Twin---ResidenceSingle room, en-suite, self-catering FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX StudioSingle room, en-suite, self-catering FORMCHECKBOX FORMCHECKBOX ------Shared room, en-suite, self-catering FORMCHECKBOX Double FORMCHECKBOX Double------ApartmentSingle room, en-suite, self-catering FORMCHECKBOX FORMCHECKBOX ------Shared room, en-suite, self-catering FORMCHECKBOX Double FORMCHECKBOX Double------If booking a homestay, please answer the following questions to help us find the most suitable accommodation:Do you have special dietary requirements? FORMCHECKBOX No FORMCHECKBOX Yes (please provide details): FORMTEXT ?????Do you smoke? FORMCHECKBOX No FORMCHECKBOX YesFamily with children? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX I don’t mindFamily with pets? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX I don’t mindARRIVAL & DEPARTURE TransfersDo you require a transfer from the airport when you arrive? FORMCHECKBOX Yes FORMCHECKBOX NoFlight no.: FORMTEXT ?????From: (airport code) FORMTEXT ?????To: (airport code) FORMTEXT ?????Date: FORMTEXT ?????Time: FORMTEXT ?????Do you require a transfer to the airport at the end of your course? FORMCHECKBOX Yes FORMCHECKBOX NoFlight no.: FORMTEXT ?????From: (airport code) FORMTEXT ?????To: (airport code) FORMTEXT ?????Date: FORMTEXT ?????Time: FORMTEXT ?????FeesPlease send the fees in full or a ?250 deposit at the time of application to reserve your place on a course. If you only pay the deposit, the remaining fees should be paid in full before the course starts. Until we receive a deposit, we cannot reserve a place for you or arrange accommodation.You can make a payment using bank transfer, credit / debit cards and other popular payment methods on our website: payPLEASE Send Your Application toadmissions@british-Booking ConditionsBy completing this form, you agree to our Booking Conditions and agree to use of your personal details in accordance with our Privacy Policy. ................
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