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Enrolment Form and Conditions

ENROLMENT FORM
Please use block letters and black ink.  When completed, please print and send this Enrolment Form, together with 2 passport photos and fees to:
RDLC,
143 Richmond Park Road
Bournemouth

Dorset
BH8 8UA 
UK.

If you cannot print this form, please contact us with your mailing address or email address and we will send you an enrolment form by post, fax or email.


First name(s) on passport:

Family name(s):


Sex:  M / F.


Date of birth (Day/Month/Year):

Age:

Home address (in your country):



Telephone:

Fax number:


Email address:

Nationality:

First language:

Occupation:

Your company’s website:

Emergency contact.  Please give details of one person that we can call in an emergency:
Name:
Relationship:
Telephone:

Course details

Course name:

Number of lessons / week:


Course dates
Start:
Finish:


Number of weeks:

What is your language level now?  (Please circle).
Beginner
Elementary
Pre-Intermediate
Intermediate
U. Intermediate
Advanced

Why are you studying this language?




Accommodation
Do you want the school to arrange a host family for you?  Yes / No.


Start date:
Finish date:


Students must notify their host families of their time of arrival at least 2 days before they arrive.All host family accommodation is subject to availability.

Do you smoke?  Yes / No.
Do you want a family with children?  Yes / No / I don’t mind.
Do you want a family with a dog / a cat / other animals?  Yes / No / I don’t mind.
Details:

Are you a vegetarian?
Yes / No.

Do you have a special diet?  Yes / No.
Details

Do you suffer from any illnesses or disabilities?  Yes / No.
Do you suffer from diabetes / epilepsy / asthma / allergies?  Yes / No.
Do you have another medical condition?  Yes / No.
Details:

Please note that if any physical or psychological condition, including anorexia or bulimia, is not disclosed on this Enrolment Form, students will be asked to leave the school and no fees will be refunded.


If you do not want the school to arrange your accommodation, please give us your address in your study destination:



Airport Transfer

Do you need (single) airport transfer?  Yes / No.
If yes, please give us your flight details:
Airport name:
Date of arrival:
Time of arrival:
Flight number:  

Insurance
Do you need insurance for your stay?  Yes / No.
(If you check “Yes”, we will add a fee for insurance cover to your invoice).  Please ask us in advance about the fees and for a description of the cover provided by our partner insurance provider.

Payment

How would you like to pay for your course?

How did you hear about the school / RDLC?

Declaration
I confirm that the information given above is correct and that I have read, understood and accept the Conditions of Enrolment.

Signed:


Date:



Red Dragon Languages Consultancy is a specialist international education advisory agency.