Application FormModern Foreign Languages 2014-15

First Name *

Family Name *

Address *

Home Telephone *

Mobile Phone

Fax

E-Mail

Date of Birth *

Sex *male

female

Start Date *.

Language *.

Spanish

French

English

Term Dates Weeks

Commencing 2014-15

21st April 2014 21st July 2014 (8 week summer term)15th Sep 2014 5th Jan 2015 30th March 2015

*Applications are also accepted mid-term, provided students understand they will need to make personal arrangements to catch up on missed work.

Payment Method Cash

Card

Bank Transfer

Cheque

LevelBeginner

Elementary

Intermediate

Advanced

How Did You Hear About

International House?

Friend

Family

Webpage

Advert in Magazine

Other, please specify below

Payment. One Term – 12 weeks - £180

Two Terms – 24 weeks - £360

Academic Year – 36 weeks - £540

Summer Term 2014 - 8 weeks £120

I have read and understood the

booking conditions *

yes

Please complete and return this form with full payment to: spanish@ihnewcastle.com

International House

7-15 Gallowgate, Newcastle upon Tyne, NE1 4SG Tel: 0191 2329551

*Please note that your course place cannot be reserved unless full payment has been received. Enrolment procedures must be completed, at the latest, by the Friday prior to your first class.