English language courses

Thank you for choosing a course at Churchill House.

Please complete the enrolment form below to reserve your place. Send the completed form to us as e-mail by clicking on the 'Send' button at the bottom of this page. If you prefer, you can print the form and send it to us by mail or fax.

If you have the time, fill in the full enrolment form below. Please note that we have also provided a short version of this form in order to save you time. We will however need some more information from you before you arrive in Ramsgate.

If you need more information on how to enrol, please choose to view our detailed enrolment information.

In this section:

· Contact us
· Short enrolment
· Full enrolment
· How do I enrol?

Your personal details
Title:	Mr Mrs Miss Ms
First name(s):
Family name:
Address:
Country:
Home telephone:
Work telephone:
Fax:
E-mail address:
Emergency contact name, address and number:
Do you suffer from any illness or disability?	Yes No
If so, please give details:
Nationality:
Mother tongue:
Date of birth:
Occupation:
Your course
Which course do you wish to follow?
Please enter the start and finish dates of your course	From: To:
How long have you studied English?
Where?
What is your level of spoken English?
What is your level of written English?
If you have taken a Churchill House on-line English test, which test did you take, and what was your score?
Test:
Percentage score:	%
Is there any other information you can give us so that we can place you in the correct level?
Work placement courses only
What kind of English course do you want to take before your work placement starts?
Please state your area of professional interest:
Home tuition courses only
Where do you want to stay?
How many hours of tuition do you want per week?
Do you require weekend tuition? If so, how much?
Do you want premium accommodation?	Yes No
What are your hobbies?
Your arrival
Arrival date:
Departure date:
Transfer service on arrival	Taxi Shared coach No transfer required
Arrival port/airport:
Are you bringing a car or motorbike?	Yes No
Do you want details of our travel insurance scheme?	Yes No
Accommodation
Do you want us to arrange family accommodation for you?	Yes No
If yes:
Do you want a single or a shared room?	Single Shared
Do you want full board in our Clubroom restaurant?	Yes No
What type of family would be acceptable?	With young children With older children Older couple Single lady With cat With dog
Do you smoke?	Yes No
Are you a vegetarian?	Yes No
If no:
Do you want us to arrange other accommodation for you?	Yes No
Please specify the type of accommodation you require:
Other information
Who is responsible for paying your course fees?
Have you studied at Churchill House before?	Yes No
If not, how did you find out about Churchill House?
Is there any other information you would like to give us at this stage?





When you are ready, just click on the 'Send' button to transmit your message. We promise that you will hear from us very soon!