Online Booking

Learn English in your teacher's home.

totally immersed in the English language

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44 (0) 117 9269400

Online Booking

Name: *

Gender:

Male Female

Surname: *

Date of Birth: *

Passport Number (visa applicants only):

Passport expiry date: *

Address: *

Postcode: *

Country: *

Home Telephone:

Student Mobile:

Nationality: *

Email: *

Repeat Email: *

Emergency Contact Name: *

Occupation:

Native Langauge:

Emergency Contact Telephone Number: *

Company:

Other Languages:

Interests and Hobbies:

Level of English:

Beginner Elementary Lower-Intermediate Intermediate Upper Intermediate Advanced

How long have you been studying English?:

I am currently studying English with:

If you have selected English for Exams and/or English Plus, please fill in the fields below

Please specify which exam (English for Exams):

Please specify which course (English Plus):

Number of hours tuition per week:

15 20 25 30

Start date (usually Sunday):

Which location would you prefer:

City Countryside Coast No Preference

End date (usually Saturday):

How many weeks do you want to study?:

WHICH LANGUAGE SKILLS DO YOU WANT TO WORK ON?:

Speaking Listening Reading Writing Grammar Vocabulary

What do you want to achieve from the course?:

Please say whether you have any special requests about accommodation (eg pets in the home), dietary requirements or allergies:

Do you smoke?:

Yes No

(please note that all our teachers do not allow smoking inside their homes)

Young Learners: Does your child have any Special Educational Needs or Medical Condition? :

Yes No

If yes, please advise details:

Which Activities/Excursions would you prefer: :

Airport Transfers - I would like to book::

teacher / taxi transfers arrival only teacher / taxi transfers departure only teacher / taxi transfers arrival and departure no transfers

How did you hear of Living Learning English homestay courses? :

Payment Method:

International Money Transfer Debit / Credit card on www.livingenglish.com

I wish to enrol on a homestay course with Living Learning English as detailed above. I have read and agree to the Terms and Conditions (opens in new window) of Enrolment.

Please confirm:

I agree with the terms and conditions

Young Learners aged 15-17:

I give my permission for my child to go out of the house unaccompanied during the day time in the local area I give my permission for my child to travel unaccompanied on local public transport

If you have any problems completing the form please call us on +44 (0) 117 9269400

Available in these languages:

27 Portland Square, Bristol, BS2 8SA. Company Number: 6132639. Tel: 44 (0) 117 9269400 info@livingenglish.com

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