For detailed instructions, see 'HOW TO ENROL' on the 'Contact' page. Sending by POST: PRINT this form, then complete it clearly in CAPITALS in black ink and – * POST it to: Small Group Courses, Windsor English Language Centre, 147 Slough Road, Datchet, Berkshire, SL3 9AE, England. Sending by EMAIL: COPY the form onto Word and send it as an attachment. (If you are not using this original form, please put the NUMBER for each question followed by your details. Please START each answer on a NEW LINE.) * EMAIL it to: Windsor.ELC@virgin.net * * * * * * * * * * * * * * * * * * * * * * * * * * * I wish to apply to enrol on a Small Group Course. PERSONAL DETAILS 1. Surname(Mr/Mrs/Miss)______________________ 2. First name(s)_____________________________ 3. Postal address____________________________ _____________________________________________ 4. Email Address_____________________________ 5. Telephone no._____________________________ 6. Fax no.___________________________________ 7. Date of birth (day/month/year)_____/____/_____ 8. Nationality________________________________ 9. Passport no.______________________________ LANGUAGE DETAILS 10. Native Language__________________________ 11. My LEVEL of ENGLISH is: (Upper-Intermediate / Early-Advanced) ___________________________________________ (To study on a Small Group Course, you should have a good Upper-Intermediate / Early-Advanced level of ability.) 12. I have learnt English for _________ years. 13. Other FOREIGN language(s) spoken __________ __________________________________________ STUDY PERIOD 14. I wish to study on a Small Group Course for___________ weeks. 15. Starting on Monday (day/month/year) ________/_________/_________ 16. Finishing on Friday (day/month/year) ________/_________/_________ 17. Do you need to apply for a Student Visa in order to come to Britain? ______ (Yes / No) If 'Yes', BEFORE sending your application to the school, please CHECK with the British Visa authorities that the Small Group Course is suitable for your Student Visa Application. ACCOMMODATION 18. Do you want the school to reserve Homestay Accommodation for you during your course? (Yes / No) _____________ (If 'No', go to question 25.) 19. Number of weeks_________ 20. Arriving on (day/month/year) (Normally Sat. or Sun.) ______/_______/________ 21. Leaving on (day/month/year) (Normally Sat.) _____ /_______/________ 22. Would you like a SINGLE room or would you prefer to SHARE a room? (Single/Share)_________________ (Shared accommodation will be with a student of a different nationality, unless you make a specific request to share with a friend or relative of your own nationality in (24) below.) 23. Do you smoke? (Yes/No)__________ (If you smoke, we will try to arrange accommodation where you can smoke: we cannot guarantee this, however.) 24. Special accommodation requirements: _______________ _______________________________________________________ 25. Who first told you about the School? ________________________________________________ 26. HEALTH (a) Are you in good health? (Yes / No) _______________ (b) Any special MEDICAL requirements? _______________________________________________ _______________________________________________ (c) Does your country have any reciprocal arrangement for you to have FREE medical treatment in England? (Yes / No)______________ (If ‘No’, please obtain appropriate MEDICAL INSURANCE.) 27. Who should the School inform if you have a serious illness or accident? (a) Name___________________________________________________ (c) Relationship to you (mother/husband/friend/etc.)____________ (d) Address________________________________________________ ___________________________________________________________ (e) Telephone no.__________________________________________ (f) Email_________________________________________________ (END of form – please see TOP for how to send to School.)