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london

ENROLMENT FORM STUDENT DETAILS*

ADDRESS*

First name Family name Date of birth (dd/mm/yyyy) Nationality Country of birth What language do you speak? Passport • Number

Male

Female

Home address

Address: City: Country: Post code: Telephone number: Mobile number: E-mail address:

• Country of issue • Expiry date

Skype ID

UK address

Emergency contact (relative or friend)

Full address

Name Relationship to you Telephone number Email adress

Post code Telephone number Mobile number

* Mandatory information

COURSES - Consecutive Course

COURSES - First Course Course details

(Please refer to our website for course fees)

Course details

IELTS

Business English

Business English Projects

Fast Track Business

Fast Track English

(PET/FCE/CAE/CPE)

MH Business Certificate Foundation Pre-Masters

London Language Experience (Free Upgrade 1 to 4 weeks depending on level) At the start of course

After the start of course (book at reception)

Preferred time (General English only) Lessons per week

(Please refer to our website for course fees)

Cambridge Exams

General English

20 (15 hours)

Morning

Afternoon

25 (18.75 hours)

30 (22.5 hours)

Any combination of our courses (e.g. General English + IELTS) Course 1 number of lessons weeks Course 2 number of lessons weeks Start date Total weeks Preferred time (General English only)

40 (30 hours)*

Morning

Afternoon

Notes

*40 lessons programme Premium Intensive AM (any 2 Main Programmes)

Afternoon Intensive PM (1 Business/Exam Main + pm General English Main)

Start date

Number of weeks

ACCOMMODATION BOOKING Do you want accommodation?

No

Yes

Arrival date must be Saturday or Sunday

Number of weeks

Airline & flight No Arrival da te (dd/mm/yyyy) Arrival time Airport Heathrow Other Departure da te (dd/mm/yyyy)

Standard z 2

Standard z 3

Standard z 4-5

Premium z 3

Standard

Student House

Executive - subject availability

Residence Premium z 2

Room options

Single room

Twin room*

*Must arrive and depart together on homestay

Name of friend

Meal plan Preferences

No

Yes

ARRIVAL DETAILS

Homestay Superior z 1-2

Do you have any learning or physical disabilities? If yes, please give details:

Do you want to book a transfer?*

No

One way

Return

*Must book if arriving after 8pm and staying in family accomodation.

Half-board

Bed & breakfast

Self-catering

Smoke

Like

Dislike

Don’t mind

Children

Like

Dislike

Don’t mind

Pets

Like

Dislike

Don’t mind

Do you have allergies?

Yes

No

Please specify

OTHER OPTIONS Express mail

Yes

No

There will be a charge of £35 for most countries.

VISA TYPE ESVV

SVV

EU passport holder

DECLARATION I confirm that I have read a copy of the Terms and Conditions and Accommodation Guidelines. I agree to abide by these Malvern House rules. Terms and Conditions are available at www.malvernhouse.com/terms Name / Signature PROMOTIONAL CODE

Enrolment  

Malvern House Enrolment

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