Enrolment Page | Active Language Learning

Tick Title

First Name(s)

Last Name(s)

Nationality

Birthday

Passport Number

Passport Expiry Date

Phone

Email

Are you a Non-EU / visa-required student?

Yes

No

Do You Require Health Insurance (Required for Work & Study)

Yes

No

Do You Require Accommodation

Yes I need accommodation

No accommodation required

Do You Require Airport Transfers

Yes

I need airport transfers

No

I don't need Airport Transfers

Type Of Course Booking

Private Booking

Agency / Partner Booking

Course Start Date

Course Finish Date

Have You Completed Our Online Level Test

Yes

No

Any Further Information or Additional Comments

I confirm I have read and accept the Terms & Conditions

I confirm I have read the Cancellation & Refund Policy

I confirm I have read and accept the and Attendance Policy