Demi-pair Registration Form

Surname(s) *

First Name *

Email *

Mobile: *

Nationality *

Date of Birth *

Postal Address

Profession

Smoker *

Yes

No

Do you have any allergies, health or dietary requiremnts *

Yes

No

Describe your allergies, health or dietary requirements

English class hours per week *

20 hours

10 hours

15 hours (Summer Only)

Level

Spoken English Level *

Advanced

Upper Intermediate

Intermediate

Demi-Pair (All Year Round)

Start Date

Exam Preparation

None

First Certificate

Cambridge Advanced

IELTS

Language School Location

Bray

Dublin

Demi-Pair Summer Special (Summer Only)

Choice of English Classes (15 Hours per Week)

MORNINGS - July - August

AFTERNOONS - Start any Monday in June - August (subject to family availability)

Start Date:

Number of Weeks

8

9

10

Final Section

A DEPOSIT OF €150 MUST BE PAID NOW. ALL FEES MUST BE PAID IN FULL 2 WEEKS PRIOR TO COURSE START. PARTICIPANTS ON THIS COURSE ARE NOT INSURED. A EUROPEAN HEALTH INSURANCE CARD SHOULD BE BROUGHT WITH YOU.

Date

t and cs *

I understand and accept the terms and conditions

Terms & Conditons

Registration Form