Spanish Lessons - Enrolment Form
Name: *
Surname: *
Date of birth: *
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Nationality: *
Profession / Ocupation: *
Home address area:
Email: *
Contact number: *
Relative to contact in case of an emergency: Please give name and contact number. *
COURSE YOU ARE APPLYING FOR *
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What is your level: (please provide proof of language level e.g. qualifications/school report) *
How do you intend to fund your studies: *
Name and address of Sponsor/Employer:
Do you have a registered disability or special education needs?
Is there any other medical information you think is relevant to tell us:
Your application must be accompanied by a tuition fee of £360 (10 weeks/two hours group lessons ), made payable to Colchester Language Academy. Bank details will be emailed after we receive the enrolment form and the place in the class is confirmed.  *
Required
Any information you give to Colchester Language Academy is entirely confidential and will only be used for the purpose of providing our language services. We do not pass any personal data to third parties. You have the right to access this information, request changes and ask it to be destroyed. Please confirm that you understand the information provided by Colchester Language Academy, and that you agree your personal data to be processed by us. *
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Finally-how did you hear about us? *
By signing this form you are confirming that all information provided is complete and accurate at the time of application. Any inaccurate or false information could result in your application being rejected. Please sign and date: *
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