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You are here: application form

Application Form (Please fill in all the boxes)

PART 1 - PERSONAL DETAILS


Email Address:		First name:
		Family name:

Male Female

Date of birth (dd/mm/yyyy):

Nationality:

First language:

Job/Profession:

Age:

Address Details in your country (If you don't know some of the details please write n/a):

Address:		Telephone:
		Fax:

Post code:

Address Details in England (If you don't know some of the details please write n/a):

Address:		Telephone:
		Fax:

Post code:

Level of English: What level are you?

Beginner. I don't speak or understand any English.
Elementary. I can say a few simple things in English.
Pre-intermediate. I can speak and understand English in some situations but with many mistakes.
Intermediate. I speak and understand English in many situations but usually make mistakes.
Upper intermediate. I usually have no problems speaking and understanding but I still make some mistakes.
Advanced. I speak and understand English almost fluently and only make mistakes in unfamiliar situations.
Proficient. I speak and understand English fluently in everything but specialised areas.

PART 2 - COURSE DETAILS
When do you want to begin your course?		How many weeks do you want to study?
Which type of course are you interested in?		What time would you like to study?

Private Lessons:

Do you require One to One lessons? yes no

If your answer is "yes", please answer the following questions.
How many hours per week?
What times?
What days?

PART 3 - PAYMENT DETAILS

Payment method:

Cash or travellers cheque Sterling cheque Bank transfer Click here for our bank transfer details

Do you need accommodation? yes no

If "yes", do you want the college to arrange accommodation for you? yes no

How did you hear about Rose Of York?

If you choose "an advertisement", please specify here

If you choose "other", please specify here

Please click here to view our conditions of enrolment I have read and accepted the conditions of enrolment yes no


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