English courses in the UK, English schools near Oxford

Surname*:

First Name*:

Other Names:

Nationality*:

First Language:

Date of birth*:

Sex*:

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?:

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?

Course Details:

Type of Course*:

Starting Date*:

Number of weeks*:

-£

for other price enquiries, please email us

Payment

Type of payment*:

Sterling Bank Cheque (drawn on a U.K. bank)
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: Barclays Bank
Bank sort code: 20-03-84
Account number: 00365637
IBAN : GB52 BARC 2003 8400 3656 37
SWIFT BIC : BARCGB22

Accommodation

Do you require Accommodation?*

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