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Registration

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First Name:

Last Name:

Email:

Agency Name:

Address:

Town / City:

County / State:

Postal / Zip Code:

Country:

Telephone:

Fax:

Website:

Course Interest:

General English	Academic Year
Examinations	Juniors
IELTS (Examination Courses)	Mini Stays
One to One

Type of Course:

Standard (15hrs:20 lessons/week)

Intensive (20hrs:25 lessons/week)

Full Immersion (40hrs:30 lessons/week)

Age Range of Students:

Interested in::

Group Courses

Summer

Individual Courses

All Year

Number of Students sent each year:

References:

Please provide details of schools you are currently representing

Reference Name:

Reference Details:

Reference Name:

Reference Details:

Suitable Contact Time:

Any Additional Info:

Please read and agree to the following:

Terms and Conditions

Groups - Adults:

Groups - Juniors:

Individuals - Adults:

Individuals - Juniors:

By clicking Register you confirm that you have read and understood all sections of our Terms and Conditions.

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