BCC - ONLINE ENROLMENT FORM Title Mr Miss Mrs First Name Last Name Date of birth Phone Number Email Nationality ARGENTINA AUSTRALIA BAHAMAS BELGIUM BRAZIL CANADA CHINA COLOMBIA CUBA DOMINICAN REPUBLIC ECUADOR EL SALVADOR FRANCE GERMANY GUATEMALA HAITI HONDURAS INDIA IRELAND ISRAEL ITALY JAPAN KOREA MEXICO NETHERLANDS PHILIPPINES SPAIN SWEDEN SWITZERLAND TAIWAN VENEZUELA VIET NAM AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ARMENIA AUSTRIA AZERBAIJAN BAHRAIN BANGLADESH BARBADOS BELARUS BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CAPE VERDE ISLANDS CHAD CHILE CONGO COSTA RICA CROATIA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA EGYPT ERITREA ESTONIA ETHIOPIA FIJI FINLAND FRENCH POLYNESIA GABON GAMBIA GEORGIA GHANA GREECE GRENADA GUINEA GUYANA HUNGARY ICELAND INDONESIA IRAN IRAQ JAMAICA JORDAN KAZAKHSTAN KENYA KOREA KUWAIT LATVIA LEBANON LIBERIA LIBYA LITHUANIA LUXEMBOURG MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MAURITANIA MAURITIUS MONACO MONGOLIA MONTENEGRO MOROCCO MOZAMBIQUE NAMIBIA NEPAL NEW ZEALAND NICARAGUA NIGER NIGERIA NORWAY OMAN PAKISTAN PANAMA PAPUA NEW GUINEA PARAGUAY PERU POLAND PORTUGAL QATAR ROMANIA RWANDA SAUDI ARABIA SENEGAL SERBIA SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SRI LANKA SUDAN SURINAME SWAZILAND TAJIKISTAN THAILAND TOGO TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED STATES URUGUAY UZBEKISTAN VANUATU YEMEN ZAMBIA ID Card No. / Passport No. Full Home Address Visa Requirement No Visa required Visa required Are you a sponsored student: Yes No Upload a copy of Passport Emergency contact Please give details of one person that we can call in an emergency: Relation Phone Number Please select a course you wish to study General English Language Courses IELTS preparation course Examination courses (B2 Level & C1 Level) Specialized English courses General English Standard General English 20 lessons (15 hours) Extended General English 24 lessons (18 hours) Intensive General English 30 lessons (22.5 hours) Super Intensive General English 40 lessons (30 hours) ELTS preparation course IELTS A (Intensive) 20 lessons (15 hours) IELTS B (Basic) 10 lessons (7.5 hours) IELTS B & General English 30 lessons (22.5 hours) Examination courses (B2 Level & C1 Level) Intensive option - A 20 lessons (15 hours) Intensive option - B 10 lessons (7.5 hours) Examination Course B & General English 30 lessons (22.5 hours) Specialized English courses Business English – A 20 lessons (15 hours) Business English – B 10 lessons (7.5 hours) Business English B & General English 30 lessons (22.5 hours) Course Start Date Number of weeks Please select your level Beginner Elementary Pre-Intermediate Intermediate Upper Intermediate Advanced Would you like to book accommodation Not required Yes please Accommodation Type Single room Twin room (2 people shared occupancy) Double room with single occupancy Would you like to book airport transfer Not thank you Yes please Airport LONDON Heathrow / LONDON Gatwick LONDON Luton LONDON Stansted SOUTHAMPTON BOURNEMOUTH Send
