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REGISTRATION FORM

PERSONAL DETAILS
FIRST NAME   FAMILY NAME  
DATE OF BIRTH   BIRTH PLACE  
EDUCATION LEVEL   PRIMARY SCHOOL   MIDDLE SCHOOL   SECONDARY SCHOOL   UNIVERSITY
OCCUPATION  
ADDRESS  
TELEPHONE  
 E-MAIL   
HOW DID YOU FIND OUT ABOUT US ? FRIEND   NEWSPAPER   RADIO    OTHER
COURSE DETAILS
NAME OF THE SCHOOL  
COURSE TYPE  
COMMENCEMENT DATE  
LENGTH OF STUDY     WEEK         LESSONS PER WEEK 
PRESENT LEVEL OF ENGLISH  BEGINNER   SIMPLE  INTERMEDIATE   HIGHER INTERMEDIATE   ADVANCED
ACCOMMODATION
WOULD YOU LIKE YOUR ACCOMODATION TO BE ARRANGED ?     YES    NO
TYPE OF ACCOMODATION     FAMILY, SINGLE ROOM   FAMILY, SHARED ROOM   OTHER
DO YOU SMOKE ?   YES     NO
HAVE YOU GOT ANY HEALTH PROBLEMS ?    YES     NO
DO YOU LIKE PETS ?    YES     NO
SPECIFIC REQUIREMENTS
TRANSFER SERVICE

DO YOU WANT A TRANSFER FROM THE AIRPORT?     YES   NO

   

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