Tel. (020) 8464 1883 (020) 8464 5149 Fax (020) 8325 2276

International Code (#44 (0) 20) E-Mail: bromlang24@aol.com

www.bromleylanguage.co.uk

(Bromley Language Centre is listed by the UK Department of Education & Skills

as a registered education and training provider: for confirmation see:

www.dfes.gov.uk/providersregister Registration No. 18128)

ENROLMENT FORM (please use BLOCK CAPITALS)

1. SURNAME…………………………. 2. (MR/MRS/MISS) FIRST NAMES.................................................................

HOME ADDRESS........................................................................................................................................................................

UK ADDRESS...............................................................................................................................................................................

TEL........................................... E-Mail ………………………….. FAX.........................................

MALE/FEMALE …………………………….. DATE OF BIRTH..........................................

NATIONALITY …………………………… PASSPORT NUMBER……………….. ISSUE DATE …………

3. KNOWLEDGE OF ENGLISH

Beginner o 2-3 Years o 4-6 Years o 6 + Years o

4. DO YOU REQUIRE ACCOMMODATION?

Host Family o Pension o Hotel o

(Accommodation is booked from the Sunday before the course begins)

DO YOU SMOKE?

Airport of Arrival ………… Terminal………Flight Number ……………. Arrival Date…………… Airport pick-up? (please see tariff overleaf) ...................................................

5. COURSE DETAILS

Which course would you like to follow?...................................................................................Code………

On what date do you wish to start your course? Day………………Month………………….Year………

Number of Weeks ……………… Departure Date (if known) ……………………………………………….

Do you wish to enter a Cambridge examination PET, FCE, CAE,Proficiency,IELTS?................................

6. HOW DID YOU HEAR ABOUT US?.................................................................................................................................

agreement

I wish to attend Bromley Language Centre (School of English). I have read and agree to abide by the terms and conditions of the Centre (details on Fees Sheet).

I enclose the deposit:

20% of total fees & accommodation (minimum deposit £90 school + one week’s accommodation, if required) or 50% deposit, if a student visa is required. Please note: non–EU students are obliged to attend a minimum of 15 hours’ supervised day-time lessons per week. See “cancellations” overleaf.

Please send a copy of the Bank Transfer with this enrolment form. Deposits are non-refundable.

Name..............................................................

Signature( of person responsible for paying the fees)…………………………… Date..................

Payment Details. Fees should be paid by bank transfer to:

Bank: The Royal Bank of Scotland 12 Elmfield Road, Bromley BR1 1LP, England Account Name: Bromley Language Centre, School of English Account Number: 11290366 Sort Code: 16-14-29.

IBAN (International Bank Account Number)
GB12RBOS16142911290366 Swift Code RBOS GB 21 302