Enrolment form

If you would like to enquire about enrolling at Ealinguistics, please take the time to fill in the following form.

family name
first name
gender male female
nationality
age
date of birth
occupation
home address
telephone
fax
email
Course Start Date
number of weeks
number of lessons per week 15 20 25
Which Course? (select one) General English Business/Specific English
number of years you have been learning English
Are you attending English classes at the moment? yes no
When did you last attend English classes
What would you like to have achieved at the end of your English course in London?
Please describe realistic goals:
Self Assessment (please tick the relevant buttons)
I find: very easy easy difficult very difficult
Reading
Writing
Speaking
Listening
Grammar
Vocabulary
   
Ursula Hilton-Jones
6 Delamere Road, London W5 3JR. UK.
tel: 0044 20 8567 5993
mob: 0044 7941 972 801
email: uschi@hilton-jones.co.uk