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Your course

Language chosen: *

Location: *

Title of course: *

Start date: *

Lessons per week: *

Number of weeks: *

Your accommodation

Type of accomodation required: *

Please check the college details to see what accommodation is offered. All accommodation is subject to availability but every effort is made to meet your specific requirements.

Type of room required:

Type of board required:

Name of friend (if sharing):

Do you have any allergies, or dislike of any pets?:

Details of any special requirements:

Arrival date: *

Departure date: *

Transfer required:

Do you smoke?: *

Would you prefer a non-smoking household?:

About you

Surname: *

Firstname: *

Title: *

Date of birth: *

Nationality: *

Address: *

Postcode: *

Country: *

Landline telephone: *

Mobile telephone: *

Parent's mobile telephone:

Please provide a parental/guardian mobile number as well (where applicable).

Email: *

Parent's Email:

Please provide a parental/guardian email address as well (where applicable).

Your occupation:

How did you hear about CESA:

Why did you choose CESA?:

Your language ability

How would you rate your ability?:

Language ability:

How would you rate your current language ability?

Number of years studying the language: *

Additional information

Allergies etc:

Do you have any allergies, special dietary or medical requirements that the college should be aware of?

Other information:

Is there any other information you wish us to take into consideration when making your enrolment, or any questions that you wish to ask?

Your emergency contacts

Contact name: *

Contact address:

Contact telephone: *

Select the payment currency: *

Your payment details

1. How are you paying? *

2. What are you paying?:

Deposit only (£250/€300/$350)

Full fees

Amount to pay: £/€/$ .

Special offer code:

Your final confirmation

Correspondence name:

Please give the name and address of the person CESA should correspond with if not the person enrolling. All correspondence concerning the enrolment will be sent to the details you give here.

Correspondence address:

Terms and conditions: *

Yes

I have read the Terms and Conditions on this site and accept the terms of enrolment. I will forward the required passport photos by post or email in the next few days. I have arranged paument of the deposit (or full fees if applicable) and know that no enrolment will be made until the required deposit/fees reach CESA Languages.

Agreed by: *

Student (if over 18)

Parent or guardian (if under 18)

Name: *

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CESA Languages Abroad

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