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Language Course Application Form

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SUMMARY


 

 

SECTION 1. PERSONAL DETAILS

 

Now that you have decided which course meets your requirements, registration is easy but must be done as soon as possible. The request has to arrive at least 4 weeks in advance to give enough time to organize the accommodation. 

The teachers and all the staff are anxious to welcome you to the school in New York

 

COME AND BREAKDOWN THE LANGUAGE BARRIER IN NEW YORK!

 

INSTRUCTIONS

 

Print out the application form, fill it in and enclose any other necessary documents for other programs like the Dance/English Program. The request has to arrive at least 4 weeks in advance to give enough time to organize the accommodation. Please answer all questions. All fields marked with a * are required and must be completed.

 

To be eligible for a I-20 Form A-B (F-1) Student Visa you must send with your application :A letter from your bank or a bank statement certifying that you have sufficient funds available in your account (student) or in the account of your sponsor to cover all your expenses during your stay in the United States. (This letter must be written in English and the currency in US$.). This document can be sent either by e-mail, fax or post.

 

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

 
bullet

Confirm acceptance on the appropriate program and will send you an invoice for the total owed

 
bullet

Wait for the settlement of your bill which can also be done on-line

 
bullet

Will send you the I-20 visa form and the official confirmation of the accommodation

 

 

Print out the credit card form and fax it to us on: +44 (0)870 1689892 together with the application form.  For your convenience if you prefer, you can send us your application form securely on-line. We also accept credit card payment over the phone, cheques and bank transfers.

 

First Name*

Last Name*

 

D.o.B.*

 

Place of birth:

 

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 (if different from above) Address:

 

Next of kin Tel N (country code first)

What is your mother tongue?*

Beginners: Chose course starting date: (please tick)

11th January:

1st February: 

1st March: 

5th April:

3rd May:     

 7th June: 

12th July: 

2nd August:

13th September:

4th October:

1st November:  

 6th December:

All other levels state starting date: (any Monday)

How did you find our website?*  Please quote Ref N if applicable:

 

Choice of course:*  (please tick)

Dance/English Program:

 Intensive English Business Group:

Intensive English Group:

TOEFL preparation:

Intensive English for professionals private:

Intensive English for professionals combined:

Intensive English for professionals group:

Semi Intensive English Group:  

Semi Intensive English Private:

Parallel with professional combined:

Practical Experience for young people:

Practical Experience for Professionals:

N of weeks required:*

Choice of elective classes:*  (please state 3 choices) (please tick)

American Culture:

Conversation Practice:

 Film, Radio & Tv:

Discussion on current affairs:

 Essay & Business Writing:

Intermediate Conversation:

Speaking in Public:

Pronunciation & Reduction of accent:

 

Is your elective class:* (please tick)

 

Combined to a 30 hr intensive English program:

 

In supplement to a 20 hr English Course:

 

Registration to only an elective class:

N of weeks required:*

Type of accommodation:* (please tick)

Host Family: 

Residence:

 

If a residence is required name of residence: (please tick:

Flushing Ymca: 

Il de Hirsch:

Jazz on the Park:  

Ten-Eyck Troughton:

 

Vanderbilt Ymca

Type of Room:*  (please tick)

Single Room: 

Double Room:

Do you: smoke?*

Can you live in a home with animals?*

Other useful information: (allergies, particular diet etc)

Date of arrival:*

Date of departure:*

Note: Accommodation is available only for the duration of the course. Students can arrive the Sunday before the start of the course and depart the Saturday after the end of the course.

Do you require a transfer from the airport?*

If Yes please supply arrival details:

Flight N:

Time of arrival:

Name of departing airport:

Name of airport of arrival:

Please note: we need this information at least 2 weeks prior to arrival

To speed up my application I would like to receive my I-20

 form by special delivery (34.00):

SECTION 4. PAYMENT DETAILS

Pay to:

Totalnannies.com

Payment for:

Agency Fee for language

course and accommodation

abroad

Amount:

99.00

Payment for:

Registration Fee

Amount:

70.00

Payment for:

Deposit for Accommodation

Amount:

104.00

Total due:

273.00

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

 Credit Card:    Bank Transfer Cheque: 

Conditions

1) The agency fee is 99.00 Pounds Sterling. The fee must be paid on application.

2) In the event of cancellation or failed departure on your part the agency fee under no circumstances will be refunded.

3) If we are unable to fulfill your request the agency fee will be refunded in full.

4) On application all relevant registration fees and deposits must be paid depending on the programs chosen. All these registration fees and deposits are not refundable.

5) The bill must be paid in full before departure.

6) In the event of cancellation before the start of the course, all fees will be refunded in full. The registration fees and the deposit are not refundable. In the event of cancellation once a course has begun no refund will be given.

7) Whilst every precaution is taken in the introduction of clients, we cannot be held responsible for events beyond our control.

 

I declare that I have read and accepted the conditions.

 

Signed:                                                                 Date:
 

 

OTHER PROGRAM IN NEW YORK

 

S001/USA

 

Great Britian

France

 

Germany

Ireland

 

Italy

 

 

 

Great Britain

France

 

Germany

Ireland

 

Italy

 

Spain

Switzerland

 

USA

Japan

 

 

 

Spain

Switzerland

 

USA

Japan

 

 

 

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