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 If you need to send us a separate payment for any reason, please use this payments form.

 

STUDENT DETAILS

* indicates required fields

Title

First Name

 *

Last name

 *

Street

Town/City

State/Province

Zip/Postal code

Country

 *

Nationality

 *

Occupation

Telephone

 *

Fax

Email

 *

Age

 *

SECOND STUDENT DETAILS

Two-student courses: please complete details below

Title

 

First Name

Last name

Nationality

Occupation

Age
 

SPECIAL REQUIREMENTS

Allergies and any medical or dietary needs

 

Any other special requirements

 

Do you smoke?

Is a smoking household acceptable?

Do you require a private bathroom ?
(£80 / week)

Interests

   

COURSE DETAILS

Type of course

 

English level

 

No. of weeks

 

Hours per week

 

Specialised courses:

What is your area of special interest?

   

  Cost of Course

£

 

TRAVEL DETAILS: Use Heathrow if possible

Arrive (Sunday)

Depart (Sunday)

Meet me at the airport on arrival
(Click here for prices)

Please return me on departure

Arrival details if known

Flight number
Arrival time

 

Departure details if known

Flight number
Departure time

 
 

  Cost of Transfers

£

 
   

*Please read the Terms and Conditions before
sending this form.

 

I accept the Terms and Conditions
*
 

PAYMENT

  

Course Cost

 £

 

Transfer Cost

 £

 

Private Bathroom

 £

 

Registration Fee

 £

 

TOTAL COST

 £

 
 

I wish to pay by:

 

I wish to pay:

 
   

 

If you have chosen to pay by credit card, you will be transferred to a secure server to enter payment details.

Please note that there is a charge of £15 extra if you pay by bank transfer or sterling cheque. You can send this enrolment form online by pressing the "Send booking" button after completing the form, or you can print the form and fax it to: +44 8706 221 868 or post it to: PET, 19 Sandford Park, Charlbury OX7 3TH, UK.

Bank details for bank transfers

Alliance & Leicester Commercial Bank, Bridle Road, Bootle, GIR 0AA, U.K.
SWIFT Code ALEI GB22
IBAN: GB58 ALEI 7200 0005 1347 81

Please note that Enrolment can only be considered valid after we have received your deposit or the full course payment.

   


 
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