Registration Form

Please complete this form with all the required student details

***Accurate and complete information will allow us to ensure a smooth and efficient registration process***

Agent Details

Agency Name *

Agent Name *

Agent Email *

Student Details

Full Surnames >> As they appear on the student's passport *

Full First Names >> As they appear on the student's passport *

Gender *

Date of Birth *

Nationality >> This should match the passport with which the student will be travelling. *

Photo of Passport

Click or drag a file to this area to upload.

*Not required for EU citizens

Student Phone Number

Student Email *

Course Details

Course Type *

General English – 15 hours per week – Morning
General English – 15 hours per week – Afternoon
6 Weeks IELTS Course – 15 hours per week – Morning
Work & Study – 15 hours per week – 25 weeks – Morning
Work & Study – 15 hours per week – 25 weeks – Afternoon

Type Medical be

Number of Weeks *

Course Start Date *

Exam *

TIE
IELTS
no exam

Medical Insurance >> Does the student require medical insurance booked through the school? *

Yes
No

Accommodation >> Does the student require accommodation booked through the school? *

Yes
No

Accommodation Details

Student Phone Number *

Accommodation Type *

Homestay >> Host Family
Shared Apartment

Number of Weeks *

Accommodation Start Date >> Saturday or Sunday check-ins ONLY *

Host Family Type *

With Meals (half-board) >> Breakfast & Dinner Monday to Friday. Breakfast, lunch & dinner Saturday & Sunday
Without Meals (self-catering) >> Student has access to the host family kitchen to prepare and cook food they buy themselves

Room Type in Host Family *

Single Room
Twin Room (2 single beds) >> For friends or couples travelling together only
Double Room (1 big bed for 2 people) >> For couples travelling together only

Sharing with… (enter other student's names) *

First

Last

Special Requirements *

non-smoking house
no dogs
no cats
non-applicable: The student is ok living with dogs, cats and smokers

Any dietary concerns or allergies? *

Yes
No

Please list the student's dietary concerns or allergies: *

Room Type in Shared Apartment *

Single Room
Twin Room (2 single beds) >> For couples, friends or one person – A person travelling alone can book 1 bed in the shared room
Double Room (1 big bed for 2 people) >> For couples travelling together only

Sharing with… (enter other student's names) *

First

Last

Additional Information