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Family name*:
First Name*:
Other Names:
Leave this field blank:
Nationality*:
First Language:
Date of birth*:
Sex*:
male
female
Home address:
Do you have a United Kingdom address:
Phone*:
e-Mail*:
Passport Number
Place of issue
Date of issue
How long have you been learning English?:
less than 6 months
6 months - 1 year
2 years
3 years
4 years
5 years
more than 5 years
Certificates (if applicable):
If possible please attach the certificate copy. Acceptable file formats: .doc, .jpg, .pdf
Name and telephone details of a person we can contact in the case of emergency (parents, wife, friend, etc):
Where did you hear about our school?
Internet
Leaflet
Newsagent
Friend
Advert
Other
Which magazine/newspaper?
Course Details:
Type of Course*:
General English Group Course
Business English group courses
One-to-one tuition
IELTS Preparation Course
Other
Intensity of Course*:
15 hours per week
20 hours per week
30 hours per week
Time of Course:
--
mornings (a.m.)
afternoons (p.m.)
late afternoons (p.m.)
Starting Date:
Number of weeks*:
1 week
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
9 weeks
10 weeks
11 weeks
12 weeks
13 weeks
14 weeks
15 weeks
16 weeks
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50 weeks
51 weeks
52 weeks
1 week
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
9 weeks
10 weeks
11 weeks
12 weeks
for other price enquiries, please
email us
Payment
Type of payment:
Sterling Bank Cheque (drawn on a U.K. bank)
Eurocheque / Traveller’s cheque (max. amount of £700)
Credit Card - fax or phone details to the school
International bank transfer
(
all bank charges paid by student
+ copy of transfer) - made payable to:
ELT BANBURY LTD
Our bank details: Lloyds TSB
Bank Sort code: 30-92-90
Account number: 00045509
IBAN: GB40 LOYD 3092 9000 0455 09
SWIFT: LOYDGB21053
Accommodation
Do you require Accommodation?
--
Yes
No
Homestay
Prices per week per person
Minimum booking - 2 weeks; maximum booking - 12 weeks
Arrival days for accommodation must be Sundays (or Saturdays if agreed)
Zones 3/4/5
Room type
Single
Twin*
Self Catering
£155
£145
Bed & Breakfast
£155
£145
Half-board
£180
£165
* Twin rooms are only for students who travel together
Residences
Available ONLY in the summer from end June until end August
Single room
Residence Zone 2
From £170
Limited availability. Please contact us as soon as possible to reserve your place.
If you are interested in residential accommodation during the year please e-mail
office@elsenglish.com
and we will advise you on options available and prices.
All accommodation is no more than 45 minutes commute from the school. There is a one off booking fee of £35. Twin room is only available for two students coming together who wish share a room.
For terms and conditions regarding arranging accommodation see
Terms and Conditions
Accommodation length (weeks):
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
9 weeks
10 weeks
11 weeks
12 weeks
13 weeks
14 weeks
15 weeks
16 weeks
17 weeks
18 weeks
19 weeks
20 weeks
21 weeks
22 weeks
23 weeks
24 weeks
25 weeks
26 weeks
27 weeks
28 weeks
29 weeks
30 weeks
31 weeks
32 weeks
33 weeks
34 weeks
35 weeks
36 weeks
37 weeks
38 weeks
39 weeks
40 weeks
41 weeks
42 weeks
43 weeks
44 weeks
45 weeks
46 weeks
47 weeks
48 weeks
49 weeks
50 weeks
51 weeks
52 weeks
Date of Arrival:
Time of arrival:
hs.
I have read and understood the
terms and conditions of enrolment
on the website and I confirm that the above details are correct.*
Yes
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