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Stay In Touch Online English Language Practice

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	English in Chester 9-11 Stanley Place Chester CH1 2LU
Tel:	+44 (0)1244 318913
Fax:	+44 (0)1244 320091
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Application Form

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course

I wish to enrol for

Course Dates

From: to:

To apply for a place on the Two-Centre General English Course, International Foundation Programme or the Year Abroad Programme please contact us.
To apply for the Caribbean "Cocktail" Course please see the English in Barbados website.

about you

Family Name

First Name(s)

Sex

Male Female

Date of Birth

Age

Address in your Country

Telephone Number

Fax Number

E-Mail Address

Nationality

First Language

Other languages that you speak

Profession/Study area
(if applicable)

Religion

Please give details of any medical problem or handicap the school may need to know about (e.g. diabetes):

Knowledge of English

Elementary
Lower Intermediate
Intermediate
Upper Intermediate
Advanced

Online Placement Test Score
(if taken)

Take Placement Test (new window)

Please note that the school only accepts beginners on 1-1 Courses.

Have you studied in Britain before?

Yes No

How did you learn about English in Chester?

Agent/Company
Please specify:
Friend/Relative
British Council
Internet
Guide Book
Please specify:
Other
Please specify:

accommodation

I would like the school to arrange Homestay Accommodation	Yes No

I am a smoker

Yes No

I am a vegetarian

Yes No
Please specify:

Please give details of any other special dietary requirements

Do you have any special requests? (children, pets, hobbies etc.)

English in Chester will use this information to select homestay accommodation for you but cannot guarantee that all your requests will be met.

Standard Homestay Accommodation

Half Board

Single Room
Shared Room

Bed & Breakfast

Single Room
Shared Room

Executive Homestay Accommodation
(available for students on the Intensive English Language courses for students of 25 years of age and over only)

Half Board

Single Room
Shared Room

Bed & Breakfast

Single Room
Shared Room

Full Board Supplement
(available for students on the Vacation Courses for Teenagers)

I would like a packed lunch from Monday to Friday

I would like Self-Catering Accommodation (available in the summer only for students aged 18+)	Yes No
I would like information about Hotels/Guest Houses in Chester	Yes No

travel

I shall make my own travel arrangements using public transport - please send information	Yes No
I shall come to Chester in my own car	Yes No
I shall require the meeting/transfer service from Manchester/Liverpool Airport	Yes No

I am arriving at
Date
Time
Flight Number
Coming from

confirmation

A registration deposit of £100.00 will be due to accept your application.

I have read and understand the information about enrolment, payment, cancellation, curtailment and accommodation.

Accept

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