| Please indicate your present english level. |
How long have you studied english? |
|
| Reading |
|
Writing |
|
|
|
|
|
| Speaking |
|
Listerning |
|
|
|
|
|
| Course |
|
Start Date DD/MM/YY |
|
Finish Date
DD/MM/YY |
|
| What do you need English for? |
|
| What are your objectives? |
|
| Type |
|
Do you smoke? |
|
Do you have any special Dietry needs /Illness/Disabilities? |
| Would you be happy to stay with a non-smoking family? |
|
|
|
| Is it a problem for you if your host family has pets? |
|
|
| Is it a problem for you if your host family has children? |
|
|
| For Homestay Accommodation use only |
|
| Marital status |
|
Do you have children If yes, M/F? Ages? |
|
| Place of arrival/Departure |
|
|
Flight Number
(if applicable) |
|
|
| Do you require transfer by Car? |
|
|