If you wish to enrol for a course with us please complete the application form. You may also download a word document version of our application form, pricing and terms and conditions by clicking here. If you need information with regard to our pricing then click here. Please read the terms and conditions of Enrolment by clicking here. Personal Details Surname Forename Gender MaleFemale Nationality Address Address(cont'd) City/Town Post Code Mother Tongue Other Languages Occupation Telehone No. Fax No. Other Languages Course Details How long have you studied English for?  Years  Months Course start date: 1st choice 2nd choice 3rd choice Level of English? Beginner* Pre-Intermediate Intermediate Upper-Intermediate Advanced* * These levels are not offered in the summer Accommodation Details Select accommodation of your choice: Host Family Single room Shared room Bed & Breakfast Arrival Date Departure Date Would you prefer a family with: Young Children Cats Dogs Do you smoke? Yes No Are you vegetarian? Yes No Would you prefer to be the only student in your Host Family? Yes No What do you like doing in your free time? Can you tell us any other information that would help us to choose a suitable host family for you? (e.g. any allergies, special diet etc.) How did you hear about us? The Exmouth Language School Leaflet? Through an Agent? Through a friend? Spotlight Magazine? Other? Agent's name: Other:

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