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SUMMER SCHOOL APPLICATION FORM

Please provide the following information about yourself: * These items must be completed. If you prefer, you can download a copy of our application form to complete and post back. Click here to download (MS Word Format).			P E R S O N A L I N F O R M A T I O N
*Family Name:
*Given Name(s):
*Address: (in your country)
*Tel No:		(include full international and national dialling codes)
Fax No:

E-mail address:
*Nationality:
*Date of Birth:	*Age:
*Sex:

*Please tell us about your course requirements

The cost of the Summer School is �390 per week for seniors (16+) or �420 per week for juniors (14-15), plus a �30 registration fee in both cases. Payment is by sterling cheque or bank transfer and details will be provided when you submit your application.

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*What is your intended start date?
(You can start on any Monday between
29 June and 17 August).

*For how many weeks?
(We recommend a minimum of 2 weeks).

What is your current level of English?

	Beginner
	Elementary
	Intermediate
	Advanced

*How did you hear about the Oxford Language Centre?

* Would you like us to arrange homestay accommodation for you?

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	Yes, I would like you to arrange homestay accommodation for me. (Accommodation and meals are included in the price).
	No, I will make my own arrangements for accommodation.

Do you suffer from any illness or allergy?	No	Yes
Do you have to take any medications?	No	Yes
Do you smoke?	No	Yes

Further Details of illness, allergy or medications:

Special Requests:

Would you like us to arrange an airport transfer?

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Click the "NEXT" button below to review and print your application. You will then have the opportunity to make amendments before the completed application is submitted to the Oxford Language Centre.

�2005 Abacus College & Oxford Language Centre
Threeways House, George Street, Oxford OX1 2BJ, England
Tel: +44 (0)1865 240111 Fax: +44 (0)1865 247259
www.olcoxford.co.uk

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