First name(s)
 
Family name(s)
Title
Sex
Date of birth(D/M/Y)
Age

Home address

Telephone
Nationality
Occupation
Fax number
First language
E-mail address
 
 
Please give details of one person that we can call in an emergency
Name Relationship Telephone number
 
 
Please mark the box
General English Standard Course (20 lessons = 15 hours per week)
General English Intensive Course (28 lessons = 21 hours per week)
Cambridge FCE Exam Course
Cambridge CAE Exam Course
Cambridge CPE Exam Course
IELTS Exam Course
Business English
Tourism and Hotel Management English
Medical English
Military English
Business Studies
Travel and Tourism
University Foundation Programme
1:1 Course (Number of lessons = )
other
Course dates .Start .Finish  
Number of weeks  
  
 
Beginner
Elementary
Pre-Intermediate
Intermediate
U. Intermediate
Advanced
Beginner-level students must start on published course start dates. Please check our course descriptions for entry requirements for your chosen course.
Holiday
Start Finish
Please note that any holidays (apart from official bank / public holidays) must be booked at the time of enrolment.
 
   
 
Do you want ETC to arrange a host family for you? YES NO  
What kind of room would you like? Single room
Twin room*
Executive accommodation 		 
* Twin rooms are available if you book with a friend to share your twin room. If you come alone, ETC cannot guarantee to find you a twin share.
Start date Finish date
Students must notify their host families of their time of arrival at least 2 days before they arrive. All host family accommodation is subject to availability.

Do you smoke?YES NO
Do you want a family with children?YES NO I don't mind
Do you want a family with a dog / a cat / other animals?YES NO I don't mind
Do you have a special diet?YES NO

Details:


Do you suffer from any illnesses or disabilities?YES NO
Do you have another medical condition?YES NO

Details:

Please note that if any physical or psychological condition, including diabetes, epilepsy, asthma, allergies, anorexia or bulimia, is not disclosed on this Enrolment Form, students will be asked to leave the College and no fees will be refunded.

If you do not want ETC to arrange your accommodation, please give us U.K. address:
 
 
 
Do you need airport transfer?YES NO          Single Return
If yes, please give us your flight details:
Airport name Date of flight  
Time of flight Flight number
 
 
Do you need insurance for your stay at E.T.C?
(If you write "Yes", we will add a fee for insurance cover to your invoice)
 
   
 
I confirm that the information given above is correct and that I have read, understood and accept the Conditions of Enrolment.