Enrolment Form: The Language Centre - 2017/18 Esol Programme
Enrolment Form: The Language Centre - 2017/18 Esol Programme
Enrolment Form: The Language Centre - 2017/18 Esol Programme
Enrolment Form
Please return a signed copy of this application form, with your payment, to:
THE LANGUAGE CENTRE (CIC), General office- 6, Old Eldon Square (3rd floor), Newcastle upon Tyne, NE1 7JG
Your details
First name: Title (Mr.Mrs.Miss.Ms.Dr.Pr)
Surname:
Address:
Town: Postcode
Home tel number: Mobile:
E-mail address:
Gender : Male Female
Date of birth: Nationality:
Mobile number of Person to contact in an emergency:
Your Highest Academic Qualification (GCSE, A-Level, Degree...):
Your first language (mother tongue):
Disability (we will not disclose this information to anyone unless you give us permission)
Do you have a medical condition, disability which you feel we should know about? Please provide full name and
details of your condition. Please note that the TLC general office and rooms in Old Eldon Square do not have
disabled access.
Payment methods
You can pay for your course On-line:
3. By cash or cheque: (Cheques should have your name and address printed clearly on the back. Please make
payable to The Language Centre (CIC), and send to or visit:
(We will not disclose any personal information to anyone unless you give us permission)
Prospective students should consider their circumstances very carefully, and whether they have enough time to
dedicate to learning a language in addition to their academic workload and/or other commitments. The refund
policy applies in all cases, and refunds due to exceptional circumstances which arise after enrolment are at the
discretion of the director of TLC