Online Application Form 2024 – Inlingua Cheltenham

Contact Details

Gender(required)

First Name(required)

Last Name(required)

Nationality(required)

Date of Birth(required)

Address(required)

City

Country(required)

Post Code(required)

Mobile number(required)

Home telephone(required)

Email address(required)

Passport Number(required)

Visa requirements

Upload your picture(required)

Maximum size 10MB

Medical Conditions and Dietary Requirements

Do you smoke?(required)

Yes

No

Do you have any medical conditions / Allergies

Condition

Medication

Special diet

Emergency Contact Details and Relationship to Student

Please provide an emergency English speaking contact.

Relationship to student(required)

Emergency contact name(required)

Emergency contact number(required)

Emergency contact address(required)

Agency Contact Details

Do you have an agent representing you

Name of agent

Agent email address

Promotion Code

Address

City

Postcode

Course Details

Course 1(required)

Course 2(required)

English Level(required)

Start Date(required)

Finish Date(required)

No. of weeks(required)

Travel Details

If traveling by plane please state the following:

Do you require a transfer from the airport?

I want inlingua to organise my transfer as follows:

Flight Arrival Time

I am arriving at

Flight Number

Airline

Departure date

Time of Departure

I am departing from

Flight Number

Airline

Accommodation Requirements

Do you require accommodation

No

Yes

Accommodation type

Board

How did you hear about us?

I heard about you from:

Methods of Payment

How to pay

By bankers’ cheque (in pounds sterling drawn on a UK bank)

By bank transfer in pounds sterling (account details on the invoice you will be sent)

Through my inlingua school or Agent or Representative

Please confirm you wish to enrol with inlingua Cheltenham as detailed above. You also confirm you have read and agree to the Terms and Conditions of Enrolment. (required)

Yes

Pay online here: https://inlingua-cheltenham.paytostudy.com/

Email address(required)

Are you human?(required)