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Language Course Application Form

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SUMMARY

 

 

 

 SECTION 1. PERSONAL DETAILS

 

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Print out the application form, fill it in . Please answer all questions. All fields marked with an * are required and must be completed

 

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Once your application has been received you will be given a reference N° that you will need to quote on all correspondence, e-mails or when contacting us by telephone

 

 

 For your convenience if you prefer, you can send us your application form securely on-line. We also accept payments by cheque and bank transfers.

First Name*

Last Name*

D.o.B.*

Age:*

Gender:*

 

Nationality:*

 

Home Tel N° (country code first)

 

Work Tel N° (country code first)

 

Mobile Tel N° (country code first)

 

Fax N° (country code first)

 

E-mail

Address:

Next of kin Address: (if different from above)

 

 

 

Next of kin Tel N°: (country code first)

Present Employment:*

 

Name of work place:

 

Work Address:

 

 

Date of arrival:*

Date of departure:*

How do your rate your current level of French?* (please tick)

 

Beginner:

 Elementary:

 Intermediate Inferior:  

Superior Intermediate:

   Advanced:

 

Type of course required*: (please tick)

 

"A la Carte" 15 hrs:

"A la Carte" 30hrs:  

Business French:

 Customized Course:  

Exam Preparation:

 French Teacher:  

Group Course 15 hrs: 

Group Course 15 hrs & 4 hrs individual lessons:  

Group Course 19 hrs:

Group Course 23 hrs:  

Group Course 25 hrs:  

Individual Course 10 hrs:

Individual Course 15 hrs:

 Individual Course 25 hrs:

   Individual Course 30 hrs:  

Intensive Weekend:

Extra services required: (please tick)

 

Cookery Course: 

 Lunch with teacher:  

Outings:

 Welcome at the airport:

 

Choice of accommodation:* (please tick)

 

Host family: bed &breakfast:

Host family: half board:

2 star hotel: bed & breakfast:

3 star hotel: bed & breakfast:

4 star hotel: bed & breakfast:

Residence:

SECTION 4. PAYMENT DETAILS

Pay to:

Totalnannies.com

Payment for:

Agency Fee for language

course and accommodation

abroad

Quantity:

1

Amount:

£99.00

I wish to pay for the registration fee by (please tick)

  Bank Transfer: Cheque: 

 

Conditions

 

1) The agency fee is equivalent to £99.00. It is inclusive of all expenses. The agency fee is due on application.


2) In the event of cancellation or failed arrival on the student’s part the agency fee in no circumstances will be refunded.


3) If we are unable to satisfy the student’s request the whole fee will be refunded.


4) The total tuition and accommodation fees are to be paid to the agency within 60 days before date of arrival.


5) In the event of cancellation within 14 days from the start of the course, tuition and accommodation fees will be refunded after having deducted £143.00. In the case of cancellation less than 14 days before the start of the course, tuition and accommodation fees will be refunded, after having deducted 1 week’s tuition and 1 week’s accommodation fees. In the event of cancellation after the course has already started no refund will be given.


6) No compensation will be given for days when the school is closed because of national or religious holidays.


7) The school does not accept responsibility for any loss or damage to students in any form.


8) Fees are calculated on the number of weeks of tuition from Monday to Friday and accommodation from Sunday to Saturday morning. A week started but not finished will be calculated as a whole week.

I declare that I have read and accepted the conditions.

Date:

Signed:

 

Great Britian

France

 

Germany

Ireland

 

Italy

 

 

 

Great Britain

France

 

Germany

Ireland

 

Italy

 

Spain

Switzerland

 

USA

Japan

 

 

 

Spain

Switzerland

 

USA

Japan

 

 

 

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