Application - English As You Like It - Intesive Residential English Courses

Bewerbungsformular

Fuellen Sie bitte das Formular aus, um den Kurs zu buchen. Alle Angaben sind freiwillig. Dann druecken Sie bitte SUBMIT.

Ausserdem erreichen Sie Phil Huffman per e-mail, per Telefon (0044-01638-741743), oder per Post (Adresse siehe unten).


*Student details*
First name		Sex	Male Female
Surname		Date of birth	dd/mm/yy
Nationality		Telephone no
Smoker	Agrees not to smoke in the house
Any health problems
Dietary preferences
Email address
Address
*Next of kin details*
First name		Sex	Male Female
Surname		Date of birth
Relationship		Title
Nationality		Telephone no
Email address
Address
*Course Details*
Arrival date		Depature date
Transfer required from		Transfer to
Hours tuition per week
*Student's knowledge of English*
Speaking		Reading
Listening		Writing
Special course requirements
*Additional Details (please describe yourself, your hobbies, interests, likes, dislikes, etc)*
About You
Submit		Clear

Phil Huffman
Providence House
Ness Road
Burwell
Cambs CB5 0DB
Tel: 01638-741743

Modified 14-Mar-2002