Czech Language Course: Autumn Term 2017
Please fill in all the details. The fields marked * are compulsory.
PART 1/8: Personal details
Title
Your answer
First name
Your answer
Surname
Your answer
Date of birth
Your answer
Occupation
Your answer
PART 2/8: Contact details
Address
Your answer
Postcode
Your answer
Mobile
If you do not have a mobile, please type "N/A".
Your answer
Phone number
Fill in if you do not have a mobile.
Your answer
E-mail
Please give us your email address so that we can send you updates about your course.
Your answer
PART 3/8: Course details
AUTUMN TERM 2017

18 September – 15 December 2017 (12 weeks)

Enrolment runs until Thursday 8 September 2017

Payment by bank transfer £200 (£170concs.)
Payment by cheque £201.50 (£171.50 concs.)*
*an administration and bank fee of £1.50 applies for cheque payments

Courses:

​Beginners 1a
Thursday 21 September – Thursday 14 December 2017
1st term, tutor tbc.

Beginners 1c
Wednesday 20 September – Wednesday 13 December 2017
3rd term, tutor: Adéla Herbsová

Lower Intermediate 1a
Thursday 21 September - Thursday 14 December 2017
1st term, tutor: Adéla Herbsová

Lower Intermediate 1d
Tuesday 19 September – Tuesday 12 December 2017
4th term, tutor: Ivona Klemensová

Upper Intermediate 1b
Thursday 21 September – Thursday 14 December 2017
tutor: Adéla Barošová

Upper Intermediate II
Monday 18 September – Monday 11 December 2017
tutor: Ivona Klemensová

Upper Intermediate III
Tuesday 19 September – Tuesday 12 December 2017
tutor: Adéla Barošová

Advanced I
Wednesday 20 September – Wednesday 13 December 2017
Tutor: Renata Clark

Advanced II
Monday 19 September – Monday 11 December 2017
Tutor: Zdeňka Svěráková

Course title
Please choose your course title
PART 4/8: How did you find out about this course?
Referral
Please check all that applies.
PART 5/8: Cancellations and refund policy
CHANGES TO ADVERTISED COURSES

We reserve the right to change course tutors from those advertised and to cancel classes or close them if necessary. The listed courses or courses on request will take place if there are six or more students, in which case concessions as listed above are applicable. If there are fewer students we might consider running the course(s) but the price will depend on the number of students and there will be no concessions available.

REFUNDS

We are committed to ensuring that each listed course takes place. We will refund your fee if the course is cancelled or closed due to an insufficient number of students or for any other reason beyond our control and no alternative is available.

We willl refund your fee provided your written request is received at least a week before the course is due to start.

Our classes are planned for a limited number of students. For this reason we regret that fees are not refundable once the course has started and that no partial refund can be granted for classes not attended. CZECHTRANS cannot accept any responsibility for unforeseen changes in students' circumstances that may prevent attendance.

PART 6/8: Fees
There is either a standard (full) fee or a reduced (concessionary) fee.
You are eligible to pay the reduced fee when you provide us with evidence for one of the below:

1) You receive income-based benefit / Jobseeker’s Allowance
2) You are over 65
3) You are a full time student

At the time of enrolment, your evidence must be dated within the last 6 months and show that your benefit claim is on-going. (allowance appointment booklets are not valid evidence). We regret that we cannot enrol you at concessionary fee if you fail to provide the requested evidence. Exam fees and course books are not included in the course fee. The course price is set for each term and is valid also for students joining the course at later stage. We regret that we cannot accept payment of fees by installment. We reserve the right to refuse admission.

Payment can be made via bank transfer, a cheque payable to CZECHTRANS LTD. An administration and bank fee of £1.50 applies for a cheque payments.
You should make the payment on the same day as filling in your online application to ensure your place on your chosen course. Please note that due to limited places on each course, enrolment runs on a first-come first-served basis. You can be enrolled only if we have received both your application form and payment.

///

Sort Code: 16-00-53
Acc. No.: 10903991
Acc. Name: CZECHTRANS LTD
Give your name as a reference

Fee
Please indicate which fee applies to you. To claim a reduced fee you must provide appropriate documentary evidence at the time of enrolment. If it is not available at this time, you will be required to pay the fee in full.You must provide evidence of your situation each term to claim a reduced fee, although over 65s need only provide it once. The documents can be scanned and sent to mcdougal@czechcentre.org.uk.
PART 7/8: Data protection & Sign up for the Czech Centre newsletter
Your personal information will be at no time passed to other organisations for marketing or sale purposes.
Newsletter
Would you like to be added to the Czech Centre mailing list and receive e-mail newsletter about future events?
PART 8/8: Terms and Condition
I agree to abide by the rules of the CZECHTRANS including the refund and cancellation policies. I agree to notify the CZECHTRANS of any changes to my personal circumstances which could affect my entitlement to a reduced fee. I am satisfied that appropriate information about the course was available to me prior to enrolment.

I confirm my intention to attend the course I have enrolled on and I am aware of the commitment required. I understand that should I fail to attend my course for a period of four consecutive weeks or more, I will automatically be withdrawn from the course.

I understand I won’t be enrolled if I fail to provide the CZECHTRANS with enrolment form and/or payment by the deadline date – CLOSING DATE FOR ENROLMENT IS FRIDAY 8 SEPTEMBER 2017.

Please note: Fees are exclusive of books. The Czech Centre is closed on Bank Holidays. Courses which fall on these dates will be rescheduled accordingly. We reserve the right to refuse admission.

Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms