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English Courses Online Registration Form

 
About you
 
Title*
 
 
First Name*
 
Last Name*
 
Other Name:
 
Address*
 
 
 
 
 
 
 
Post Code:*
 
 
Country:*
 
 
Nationality:*
 
 
Gender:*

 
Daytime Telephone No.*
 
 
Evening Telephone No.
 
Mobile Telephone No.
 
 
Fax No.
 
E-mail*
 
Date of Birth*
 
Common European Framework Reference:
 
How do you rate your current English level?:*





 
Course Details
 
Intended course
(please tick)*



 
Intended Start Date:*
;
 
Intended length of course
(number of weeks)*
 
Will you be paying for the course yourself?:*

 
Will your Embassy be paying the course fees:*


If you have selected yes, what is your Embassy reference and can you provide some more details?
Reference:
Details:      
 
Have you come through an agent?:*


If yes, please enter the name of the agent:
Agent:       
 
Have you come through another Sponsor?:*


If yes, please enter the name of the other Sponsor.
Sponsor:    
 
Accommodation
Please state your preference regarding accommodation
 
Do you require Leeds Languages to arrange your accommodation? :*

 
If yes, please state your preference: :*


Do you smoke?:*

 
Health
Do you have any health or medical problems? Please describe them here.
(We strongly recommend that you take out adequate medical insurance during your stay in the UK)
 
 
Airport Transfer
Do you require collection from the airport? If so, please give flight details (arrival airport, date of arrival, time of arrival, flight number).
 
Intended course of study
after this course, if any
(e.g. BA, MA, Foundation Year)

Booking Conditions
  1. All fees must be paid 14 days before the course starts.
  2. Courses can only be cancelled by sending written notice to Leeds Languages. If this notice is received 14 days or more before the course is due to start, a refund of all monies paid (less the deposit) will be made. If a student chooses to leave their course early for any reason (or cancel within 14 days of the course start date) then no refund will be made.
  3. Leeds Languages reserves the right to modify a course if numbers are insufficient.
  4. If Leeds Languages is obliged to cancel a course, Leeds Languages will notify students immediately, and offer an alternative course or a refund of all monies paid.
  5. Leeds Languages shall not be liable for any loss, damage, injury, expense, delay or inconvenience suffered or incurred as a result of any circumstance outside the control of Leeds Languages.
  6. Leeds Languages liability in respect of any claims made shall not exceed the amount paid for tuition fees.
This agreement shall be governed by English Law and the parties hereto irrevocably submit to the exclusive jurisdiction of the English Courts in respect of any dispute or matter arising out of this agreement.


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