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5 Weeks 6 Weeks 7 Weeks 8 Weeks

Indicate Start and Finish Date

From:

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Do you wish to join the trip to London or Stratford upon Avon

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

Family Name:

First Name:

Sex:

Place of Birth:

Nationality:

Date of Birth:

First Language:

Passport Number:

Place of Issue:

Full Name:

Address:

Tel Home:

Tel Business:

Fax Home:

Fax Business:

Email:

Occupation:

Full Name:

Address:

Tel Home:

Tel Business:

Fax Home:

Fax Business:

Email:

Occupation:

Number of years studying English:

Current level of English: Beginner Intermediate Advanced

How did you hear about the course:

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

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

An initial payment of £100 and also a photograph enclosed 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