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Please answer all questions marked *

Family Name: *

First Name/s: *

Gender *

Male Female

Date of Birth: *

Nationality: *

Are you a Student Visa applicant? *

Yes No

If yes, please give your Passport Number & Passport Expiry Date:

Full postal address: *

Your language: *

Telephone number: *

Email: *

What date do you want to start your course? * Starting date must be a Monday

For how many weeks do you want to study? *

How many hours per week do you want to study? *

15 hours (mornings Mon-Fri) 22 hours (mornings Mon-Fri, afternoons Mon-Thurs) 7 hours (afternoons Mon-Thurs)

What course do you want to take? — Registration fee for all courses is £30 *

General English (7, 15 or 22 hours a week) Cambridge (FCE or CAE - 15 or 22 hours a week) IELTS (15 hours a week) Academic Year Programme (15 or 22 hours a week)

Where did you hear about Milner School?

Internet Brochure Friend/Family Agent — if yes, agent's name:

Do you want Milner School to arrange your accommodation during your English course? *

Yes No

If you answered no, please submit your enrolment at the bottom of this page.

If you answered yes, please show your choice of accommodation by selecting one of the following options

Homestay

Single room, half board, 2010: £150 per week2011: £160 per week Single room, breakfast, 2010: £110 per week2011: £115 per week Shared room, half board, 2010: £130 per week2011: £140 per week Shared room, breakfast, 2010: £100 per week2011: £105 per week

If you selected a shared room for homestay, please tell us the name of the person you will share with

Do you want a private bathroom at your homestay? (extra £80 per week)

Yes No

Liberty Fields Residence (Please note that Liberty Fields is fully booked for the summer months of July & August)

Small single studio, £200 per week Standard single/twin studio, £220 per week Large single/twin/double studio, £230 per week Deluxe single/twin/double studio, £250 per week

Furzedown Student Residence (only available in the months of July & August)

Single room, shared kitchen & bathroom £133 per week

Struan House Residence

Single en-suite room with private bathroom, £120 per week Single room, shared bathroom, £95 per week Twin room, shared bathroom, £85 per week

Write any food you cannot eat:

Do you smoke?

Yes No

Do you have any allergies or other medical/psychiatric conditions?

Yes No

If yes, please specify:

Please enter the date you wish to start your accommodation (must start on a Sunday)

Please enter the date you wish to finish your accommodation (must end on a Saturday)

Please Note: Accommodation check-in must be a Sunday and check-out a Saturday. The number of weeks' accommodation must be the same as your course. We arrange accommodation for courses of 15 hours a week or more. You will receive your Homestay address 7 days or more before you leave home. If you leave your accommodation, 2 weeks notice must be given.

Is your flight to London confirmed?

Yes No

If yes, what is your flight number & airline?

What is the date of your arrival?

What is the time of your arrival?

am pm

Which airport will you fly into?

Do you require Milner School to arrange transfer from the airport to your homestay? (If yes, you must send £75 Airport Transfer Fee with your enrolment. The fee in 2011 is £80)

Yes No

Please read Milner School's REFUND POLICY carefully before enroling:
In order to receive full course and accommodation refund, we require a minimum of 7 days notice, prior to the course starting date. After the course has started, tuition fees are non-refundable. Homestay fees are refundable if 2 weeks notice is given. No refund is given for non-homestay accommodation, Registration Fee and Accommodation Placement Fee. Cancellation insurance is strongly recommended.

I have read and accept the REFUND POLICY.