| Personal Information |
| Family Name |
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| Given Name |
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| Other Name |
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| Address |
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| Address 2 |
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| City |
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| State/Province |
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| Country |
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| Zip/Postal Code |
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| Phone Number |
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| Fax Number |
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| E-Mail |
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| Date of Birth |
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| Country of Birth |
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| Country of Citizenship |
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| Your language level now |
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| Occupation? |
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| Employer or school name? |
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| Health |
| Do you have any existing medical conditions/alergies? |
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| If yes please specify |
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| Do you smoke? |
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| Will you be willing to smoke outside? |
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| Insurance |
| Medical and Baggage Insurance |
Sydney: $515.00, Rest of the World: $640.00 |
| Do you wish to take our Medical and Accident Policy? |
|
| (Please note, it
is obligatory for all student traveling abroad to have medical insurance- see enrolment
information.) |
| Do you wish to take our Calncellation Insurance for $100 covering ill-health for
yourself and immediate family? |
|
| International Courier
Service ($100) |
| Do wish to have your enrolment confirmation, visa documents and pre-departure
information package sent to you by international courier? |
|
| Course Start Dates |
| When would you like to start? |
|
| Choice of School |
| Where would you like to study? |
|
Please Note: Students starting their course in September at schools in the
UK, Ireland, Malta, Canada, Australia, or Santa Barbara (USA) who wish to take a Cambridge
Exam in June, should extend their course by two weeks.
Check here if you wish to extend
your course at an additional cost of $380. |
Guaranteed internships are available for a placement fee of $475, at all
your schools in England, the USA, Canada, Australia, and Nice.
Check here if you would like to
enroll in the Internship Option, and are at least 18 years old. |
| Accomodation |
| I would prefer |
|
| |