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Booking Form

Home Tuition Course Booking Form

By completing this booking form I consent to the processing of my personal data for the specific purpose of booking a course with Living Learning English.

Please read our full Privacy Policy here which informs you of the data we hold about you, why we hold it and what we do with it.

First Name: (*)

Surname: (*)

Gender: (*)

Male
Female

Date of Birth (*):

Nationality: (*)

Passport Number (visa applicants only):

Passport expiry date:

Address: (*)

Postcode: (*)

Country: (*)

Home Telephone:

Student Mobile: (*)

*Must be your own mobile - we will not use this for marketing.

Email: (*)

*Must be your own email - we will not use this for marketing.

Emergency Contact Name: (*)

Emergency Contact Telephone Number: (*)

Student Occupation:

Company:

Interests and Hobbies:

Native Language (s): (*)

Other Languages spoken and level (Elementary, Intermediate, Advanced):

Current level of English: (*)

How long have you been studying English?: (*)

I am currently studying English with: (*)

I AM ENROLLING FOR: (*)

Please specify which (English for Exams) exam:

Please specify which (English Plus) course:

Number of hours tuition per week:

Start date (usually Sunday):

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?:

Which location would you prefer:

City
Countryside
Coast
Any

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 none of our teachers allow smoking inside their homes)

Young Learners: Does your child have any Special Educational Needs (e.g. dyslexia)? (*)

Yes
No

If yes, please advise details:

Does the student have any medical conditions? (*)

Yes
No

If yes, please specify details:

Which Activities/Excursions would you prefer:

Airport Transfers - I would like to book: (*)

Extras (please see brochure for fees). I would like to book:

A private bathroom
One extra night homestay
Two extra nights homestay
Accompanying adult (no tuition)
Accompanying child (no tuition)
Additional 1:1 tutorial
Christmas supplement
New Year supplement
Visa documents by express mail
Extra excursions

If you are booking extra excursions, please note requests here:

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

Please confirm: (*)

I agree with the terms and conditions

Booking Form

Accredited by the British Council for the teaching of English in the UK

Quality English

English UK Member

Education Stars - 2015 Award By Students - Best Language School in England

ST Star Awards - Shortlisted 2015 - English Language School Europe

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27 Portland Square, Bristol, BS2 8SA, UK
Tel: 44 (0) 117 926 9400 E: info@livingenglish.com
Company Number: 6132639

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