Studio School of English, Cambridge
from Chris Wright, Cambridge Language Consultants
Application to Study English |
| Information about you |
| Title: (please tick) |
Dr...... Mr....... Ms....... Miss....... Mrs..... Rev......
Sir....... Prof |
| First Name:
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| Last Name:
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| Sex: (please tick) |
Male.................... Female......................
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| Date of Birth:
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Day...........Month........................................
..........Year.................... |
| Nationality:
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| The language you speak at home: |
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| Home Address: |
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| Home telephone:
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| Daytime telephone: |
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| Fax:
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| E-mail:
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| About your course |
| Course name: (Circle one) |
EFL 20
EFL 28
(Option 1....2....3....4.....)
Cambridge Examination Course FCE CAE
IELTS Examination Course
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| You can take private lessons either as a course on their
own, or as a supplement to another Studio course. If you want Private
Tuition, please tell us how many lessons per week you would like: |
.....................lessons |
| Course start date: |
Day.............................Month......................................Year................. |
| Course end date: |
Day.............................Month......................................Year................. |
| Duration of course: |
...........................weeks |
| Your current level of English: (Circle one) (if
you are unsure about your level, click here for descriptions) |
Beginner
Elementary
Lower Intermediate
Intermediate
Upper Intermediate
Advanced |
| |
| Accommodation |
| Do you wish Studio to arrange your accommodation? |
Yes...................No........................ |
| If yes, please choose: (Circle one) |
Homestay Three Star (no extra charge)
Homestay Four Star (add £30 per week)
Homestay Five Star (add £110 per week) |
| Do you smoke?
|
Yes.......................No.................................... |
| Do you have any special health needs, dietary needs or allergies?
Please tell us about them here. |
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| Meeting on Arrival and Transfer to Cambridge |
| Do you wish Studio to arrange a car or taxi to meet
you on arrival:
|
Yes........................No............................. |
| If "Yes", at which airport or seaport will you
be arriving? |
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| Please send us your arrival details (airline, flight number,
date, time of arrival, etc.) at least seven days before arrival. |
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|
| Calculating Your Fees |
| Please refer to the Course
Dates and Fees before completing this part of the form. |
| Total Fees |
|
| A. Registration Fee (paid once) |
£50 |
| B. Total fees per week = £........ x number of weeks........
= |
£..... |
| C. Homestay Four Star: (Add £25 per week) |
£ .......................... |
| D. Homestay Five Star: (Add £110 per week) |
£ ........................... |
| E. Arrival Transfer Fee (See
Course Dates and Fees): |
£ ............................ |
| F. TOTAL = A+B+C+D+E |
£....................... |
| |
|
| Less Optional Deductions |
|
| G. No insurance required (Deduct £3.00 per
week) |
£- .......................... |
| H. No accommodation required (Deduct £90.00
per week) |
£- ........................ |
| I. TOTAL DEDUCTIONS |
£- ........................... |
| |
|
| GRAND TOTAL (F - I) |
£ ...................... |
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| When to Pay Your Fees |
| All fees must be received by Studio Cambridge no less than
four weeks before the start of your course. |
If your course starts more than four weeks after sending
us this application
You can send us: Either |
| The registration fee of £50 and a deposit of £250
(total £300). The remainder of the fee must be paid no less than
four weeks before you start your course.
Or
All fees (the Total fees plus airport transfer fee, if applicable) |
I will send the registration fee and deposit now..........
I will send all fees now............... |
| If your course starts less than four weeks after sending
us this application form |
| You must send the Total Fees as soon as possible (plus airport
transfer fee, if applicable) |
I will send all fees now.................. |
| If you send payment by bank transfer, please send a copy
of the transaction by fax or post. |
| |
|
| How to Pay Your Fees |
| Payment must be in £ Sterling, by cheque drawn
on a UK bank, bank transfer or credit card. Please indicate your choice
below. |
| I wish to pay by: (please tick one) |
Cheque drawn on a UK bank...................
Bank transfer......................
Credit card.......................... |
| |
|
| Bank transfers should be made to: |
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Account Name:
Account Number:
Bank Name:
Sort Code:
Bank Address: |
Studio Language Courses (Cambridge) Ltd
30885509
Barclays Bank plc
20-17-35
PO Box 326, Cambridge CB4 3UT |
| Giros should be paid to: |
|
Studio Language Courses (Cambridge) Ltd
Account Number: 280 5251
Sort Code: 72-08-06 |
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| If you want to pay by credit card: |
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| Please provide the details opposite: |
Full Name........................................................................
Type of card (VISA, Mastercard, Eurocard, American
Express*).........................................................................
Cardholder's Name....................................................................
Card Number.............................................................................
Date of Expiry............................................................................
Amount to be debited now.......................................................
Balance to be debited on Date:.................................................
Cardholder's signature ...............................................................
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| * If paying by American Express, please add 2% to the total
fees to cover part of the costs charged by American Express. |
| Your agreement |
| If you are under 18, please ask your parent or guardian
to complete this section. |
| I understand that by enrolling on a Studio course I confirm
my understanding of, and agreement with, the Terms and Conditions of Studio
Language Courses (Cambridge) Ltd.
View Terms and conditions now. I confirm that I am the applicant (if
aged 18 or more years) or the applicant's parent or legal guardian (if
the applicant is under 18 years of age). |
I hereby confirm.......................... |
| I confirm that I am in good health and do not suffer from
any physical, mental or nervous illness or disability, except as detailed
here: |
I confirm.........................
Details:........................................................................................
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| Date of Confirmation: |
Day................Month.............................................Year..................... |
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| If you are the guardian or parent, please complete the rest
of this section |
| Name:
|
................................................................................................... |
| Address: |
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....................................................................................................... |
| Home telephone number: |
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| Work telephone number: |
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| Fax:
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| Would you like Studio to send you a brochure? |
Yes........................No.................................. |
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| Signature of Applicant or Guardian: |
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Introduced by Chris Wright, Cambridge
Language Consultants |