The Slaney Language Centre, English Language School in Wexford, Ireland

Booking Form

Title:

First name:

Telephone:

Surname:

Fax:

Address:

Email:

Postcode:

Date of Birth:

City:

Nationality:

Country:

Occupation:

I would like to apply for the following course(s):

General English Group Course Intensive
General English Group Course Intensive Plus 4
General English Group Course Intensive Plus 10
One-to-One Course
Two-to-One Course	Name of Second Person:
Business English for Executives
English for parents and children (Easter)
English for parents and children (July)
English for Parents and children (August)
English and Culture - Study English during the Wexford Opera Festival (50+)
First Certificate Exam Preparation Course
Course as individually arranged with the Slaney Language Centre
Evening Classes (Part time)
English and Work Experience Programme
English and Internship Programme

Further requirements :

Knowledge of English:

Beginner (little or no English) - Only accepted for one-to-one courses
Elementary (sound knowledge of basic structures, ability to hold simple conversation)
Intermediate (studied English for several years, good knowledge of grammar, confident to use English in everyday situation)
Advanced (well developed communicative skills both formally and informally)
Further Information:

I would like to book the following accommodation:

*Full board family stay (sharing with a friend)
Full board family stay (guaranteed single room)
Self Catering Family Stay (single room)
Self-catering Accommodation as arranged with the SLC
*Courtyard B&B (double room)
Courtyard B&B (single room)
*Manor House (double room)
Manor House (single room)
*If you have selected a sharing option, please enter the name of the person you are sharing with:
Accommodation (B&B, Hotel) as arranged with the SLC
None

Other relevant information (e.g. accommodation details, special diets etc.)

I would like to begin my course on:

Monday Please Select Date

I would like to study for a period of:

I would like accommodation from

Please book a taxi for me from on - at

: . Flight number:

Please send me further information about bus and train connections from Dublin to Wexford.

Notes:

1. Please pay deposit of €150 within a weeks time
2. Full payment must be made to our bank after receipt of invoice and 3 weeks before commencement of course
3. Bank Details: Will be provided when you register.

How did you hear about The Slaney Language Centre?

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Other (please specify):

I have read and understood the Terms & Conditions laid down by The Slaney Language Centre.

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