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CELC UK

Summer School Registration Form

Please complete the registration form below. Questions marked with an asterisk (*) must be completed.

   
First Name*:
Last Name*:
Email Address*:
Re-type email*:
Level of English:
Date of Birth*: Day Month Year
Sex*:
Street Address*:
Address Line 2:
City*:
Country*:
Zip/Postal Code*:
Telephone*:
Emergency Contact Details
in your home country
  
Name*
Relationship*
Telephone*
More about you
  
Nationality*:
Do you need a visa?
For more information see http://www.ukvisas.gov.uk/en/doineedvisa

 
What is your first language?*
How long have you been studying English?
Please tell us about any special requirement – diet, physical, psychological, allergies, etc.
Please confirm that you have read and understood the TERMS AND CONDITIONS (opens a new window), and that you will send the deposit of £150 GBP (non-refundable) having completed this form*:
 
Passport No*:
If you are an agent making this booking please state your name:
Today's Date*:
Please tell us where you heard about CELC UK
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