www.StudyTrip.com
Booking / Enquiry form 2013 You can use the on-line form on our site to make a firm booking or a simple enquiry. If you wish you may print this pdf version, fill it out, scan and email it to us. To enable us to process your application swiftly please fill in all fields marked with a *. Use the Comments/Questions box for any special requests etc.
1. The course*: √ please tick choices
Choose your course location: English in BROADSTAIRS, Kent, England English in DUBLIN, capital of Ireland English in FOLKESTONE, Kent, England English in SALISBURY, Southern England English in WIMBLEDON, LONDON, England Would prefer London Would prefer Dublin Would prefer England (not London) No preference
Course type*: Refer to school for courses. ADULT COURSES (minimum age 16 to 18 depending on school) INTENSIVE general/business English STANDARD general/business English English for EXECUTIVES and professionals (business super intensive) PREPA (specially for French Grandes Ecoles) - Broadstairs only EXAM PREPARATION Specify exam: PRE-UNIVERSITY courses CULTURE courses - Specify:
Discours Direct
7,rue J-P Timbaud, 77860 St Germain-sur-Morin, France. Tél (+33) (0)970 469 111
[email protected] :
www.DiscoursDirect.fr & www.StudyTrip.com
sarl au capital de 16 000 € : RCS Meaux 417 500 584
www.StudyTrip.com
OTHER (please specify any special requests) YOUR OWN GROUP (all travelling together) Details:
TEENAGER AND JUNIOR COURSES (13 – 17 and 7 - 12) INTENSIVE English for teenagers STANDARD English for teenagers STANDARD English for juniors
Please specify course name, course code (if known): What is your level of spoken and written English? * .. complete beginner (see special starting dates) beginner elementary intermediary advanced
Length of course*: Week(s) Full term (usually 11-13 weeks) Long stay. Specify:
Course start date (always a Monday)*: (Course will start on Tuesday if Monday is a local holiday)
Discours Direct
2, boulevard de la Haye, 77600 Bussy St Georges, France. Tél (+33) (0)1 64 66 50 20 Fax 09 81 70 16 19
[email protected] :
www.DiscoursDirect.fr & www.StudyTrip.com
sarl au capital de 16 000 € : RCS Meaux 417 500 584
www.StudyTrip.com
2. You, the student: Surname*: First name*: Address*: Tel*:
Fax*:
We will only contact you by email. Please ensure you give your current email:
Email*: Date of birth*:
Sex*:
Profession:
Company (if applicable):
Eligible for "Formation continue" (France)? Yes / No Nationality*:
Mother tongue*:
3. Accommodation: Accommodation required*: Host family (recommended) Superior host family (where available) Residence Please specify: Studio (where available)
Discours Direct
2, boulevard de la Haye, 77600 Bussy St Georges, France. Tél (+33) (0)1 64 66 50 20 Fax 09 81 70 16 19
[email protected] :
www.DiscoursDirect.fr & www.StudyTrip.com
sarl au capital de 16 000 € : RCS Meaux 417 500 584
www.StudyTrip.com Shared house (where available) No accommodation (I'm making my own arrangements) Please provide details of hotels in the area
Length of accommodation*: Week(s) Full term (usually 11-13 weeks) Long stay. Specify:
Accommodation arrival date (usually a Sunday)*: Accommodation departure date (usually a Saturday)*: Further important details* Please give full details of any personal likes (pets or no pets in accomodation / smoker or nonsmoker), special diet, allergies or other health problems, shared or single room etc.
Name and address of nearest relative*:
Discours Direct
7, rue J-P Timbaud, 77860 St Germain-sur-Morin, France. Tél (+33) (0)970 469 111
[email protected] :
www.DiscoursDirect.fr & www.StudyTrip.com
sarl au capital de 16 000 € : RCS Meaux 417 500 584
www.StudyTrip.com
Transfer from airport, train station, port etc? * (Two-way unless you specify otherwise) No thank you Heathrow airport, London London Gatwick airport London Stanstead airport, London City airport Southampton airport, S. England Dublin airport, Ireland London St Pancras International (Eurostar etc) Ashford international (Eurostar) Dover ferry port Other Please specify:
Comments. Questions. Please use this box to specify any options, give further details etc.
Please enrol me on this course. I will send you the handling fee (1) on confirmation of your offer Please enrol me on this course. I'm sending you the handling fee (1) now by euro cheque Please enrol me on this course. I'm sending you the handling fee (1) now by bank transfer This is just an enquiry. Please send me an offer. N.B.: Your enrolment can only be finalised once it has been accepted by the school and after receipt of the handling fee (1). Date: Signed:
_______________________________________________
(1) Handling fee 2010: 55.00 euros (incl French VAT)
Discours Direct
7, rue J-P Timbaud, 77860 St Germain-sur-Morin, France. Tél (+33) (0)970 469 111
[email protected] :
www.DiscoursDirect.fr & www.StudyTrip.com
sarl au capital de 16 000 € : RCS Meaux 417 500 584
