ENROLMENT FORM

 

Before you enrol on a course, we would strongly suggest that you order a free copy of our brochure and/or contact us by e-mail, telephone or fax, so that we may properly advise you and help you to choose a course and type of accommodation that best suits your needs and interests.

 

Personal Details

Surname:

First Names:

Sex:    Male    Female

Address:

Tel:	Fax:	E-Mail:
Date of Birth:	Nationality:	Mother Tongue:

How did you hear about Language Courses Abroad/Spanish Study Holidays Ltd?:

Why did you choose Language Courses Abroad/Spanish Study Holidays Ltd?:

Which language would you like to study?: Spanish French German Italian

Have you studied this language?:    Yes    No

If Yes, for how long have you studied this language?:

Name and Address of the School/College at which you study this language:

Name of your language teacher:

 

Your Language Course

City in which you wish to study:	Number of weeks:
Start Date:	Finish Date:
Lessons per Week:	Name of Course: Standard Semi-Intensive Intensive

Your Accommodation

Date of Arrival:

Date of Departure:

Host Family        Yes    No

Single Room    Shared Room

Full Board    Half-Board    Bed + Breakfast

Student Residence        Yes    No

Single Room    Shared Room

Full Board    Half-Board    Bed + Breakfast

Self-catering shared student apartment        Yes    No

Single Room    Shared Room

Private studio apartment        Yes    No

Other Accommodation        Yes    No

If Yes, please specify the type of accommodation you require:

Airport Transfer (see brochure or contact us for details):    Yes    No

Insurance Cover: Standard Cover Premier Cover I do NOT require insurance

Please inform us of any allergies, special dietary requirements or medical conditions you may have:

Would you prefer to be placed in a non-smoking family?    Yes    No

If there is there anything else you think we should know about your reservation, or any questions you would like to ask please use the text box below:

Payment Details

Please note that the credit card information you supply in this form will be sent over a secure, encrypted data connection to our sales team. The encryption process may take short time to process your information - please wait for the form submission acknowledgement to be displayed. We thank you for your patience.

I confirm that I wish to be enrolled on the above course and have sent a deposit of £130 or $200 by:

Bank Transfer

Cheque (made payable to Language Courses Abroad Ltd)

Debit Card (we accept payment by debit cards with Switch and Delta signs)

Credit Card (we accept Visa and MasterCard).

Please note that there is a 2% surcharge for credit card payments.

Credit Card Details:

Type of Card:    Visa    MasterCard

Card Number:

Date of Expiry:

Name as it appears on the card:

Do you wish us to make a full payment from the card,
or just payment of the deposit?:

Deposit only    Full Payment

  

We are pleased that you have decided to enrol on one of our courses. We normally hope to confirm enrolment within 24 hours (Monday - Friday).

Please wait for confirmation from us before you make your travel arrangements.