Email: enquiries@rossall.org.uk Telephone: 0(44)1253 774204

Rossall Summer School Application Form

Indicate Start and Finish Date

From: *

   / /      

To: *

   / /      

There is an extra cost for these excursions. Places are limited and will be allocated to students who sign up first.


Student Information

Family Name: *

    

First Name: *

    

Sex: *

  

Place of Birth: *

    

Nationality: *

    

Date of Birth: *

    

First Language: *

    

Passport Number: *

    

Place of Issue: *

    


Student's Father

Full Name:

 

Address:

 

 

  

 

  

 

  

Tel Home:

  

Tel Business:

  

Fax Home:

  

Fax Business:

  

Email:

  

Occupation:

  


Student's Mother

Full Name:

 

Address:

 

 

  

 

  

 

  

Tel Home:

  

Tel Business:

  

Fax Home:

  

Fax Business:

  

Email:

  

Occupation:

  


Academic Information

Number of years studying English: *

    

Current level of English:


Other Information

How did you hear about the course:


If Press Advertising / Website / Agent / School
Recommendation please give details:

* Required fields

Please note that the offer of a place is subject to availability, the entry requirements at the time and the standard Terms and Conditions of Rossall International Study Centre and Rossall School

A non-refundable deposit of £100 and also an enclosed photograph of the student will be required to secure a place. The balance of fees is due one month before the start of the course. The cheque for initial payment and photograph should be sent to:- Mrs Gill McGachie, The International Study Centre, Rossall School, Fleetwood, Lancashire, England. FY7 8JW


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