English Plus Enrolment Form

Section 1: STUDENT’S PERSONAL DETAILS

Name:

Surname:

Nationality:

Date of Birth:

Gender:

 

 

Address:

Email:

Telephone:

Fax:

Passport N°:

Place of Issue:

FOR EMERGENCIES

Name:

Surname:

Email:

Telephone:

Fax:

Type of Course:

Course Dates:

Weeks:

Do you have a learning difficulty? (Please, answer 'Yes' or 'No')

Do you have a disability? (Please, answer 'Yes' or 'No')

If you answered 'Yes' to the above questions, please give details.

Section 2: ACCOMMODATION

Accommodation:

Nights:

Section 3: EXCURSIONS

Reserve:

Section 4: AIRPORT TRANSFERS

Do you need airport transfers? (Please, answer 'Yes' or 'No')
Airport transfers (Arrival and departure) are optional and at an extra cost of 40 Euros.

Section 5: VISA

Do you need Visa application assistance? Visa processing fee is 25 Euros and is not refundable if visa is refused. (Please, answer 'Yes' or 'No')

Section 6: HOME STAY ACCOMMODATION DETAILS

Do you have any medical problems or allergies? (Please, answer 'Yes' or 'No')

Do you smoke? (Please, answer 'Yes' or 'No')

Would you live in a home with young children? (Please, answer 'Yes' or 'No')

Are there any foods you cannot eat? (Please, answer 'Yes' or 'No')

Would you live in a home with a dog or cat? (Please, answer 'Yes' or 'No')

*If you have any other important special requests or  if you have answered Yes to these questions, please give details.

Section 7: TERMS & CONDITIONS

How to make an Application: Please complete all parts of the application forms and send them to Serapea viaggi. We will send you confirmation of your place on the course as soon as we receive your form and the course fees or a deposit.
How to Pay for Your Course: You should make payments in Euros to Serapea viaggi 50% deposit of the total fee (including accommodation, visa processing, airport transfers and any other applicable fee if any) should be paid to confirm booking. The rest should be paid 15 days prior the arrival. You can pay either by credit card or by direct bank transfer from your bank to our bank. If you want to pay by bank transfer, you must add 10 Euros for each transfer. On receipt of your deposit we will send you an enrolment certificate, accommodation details if applicable, and an invoice. Only places for which deposit has been received can be guaranteed. DO NOT FORGET TO INCLUDE YOUR NAME when you write to us or transfer money, you must make sure that your name is on the form in English. If you do not send the full fees with your application, we must receive the balance of the fees 15 days before the course begins. You will only be allowed to attend classes when your fees have been paid in full.
Courses: Please Note. If there is only one student in class for courses which the maximum number of students in class is more than one the One-to-One course structure will be applied at no extra charge. Therefore the number of lessons is reduced by half.
Public Holidays: The school is closed on public and national holidays. Public holidays in 2006 are: 10.02., 19.03., 31.03., 18.04, 01.05., 07.06., 29.06., 15.08., 08.09., 21.09., 08.12., 13.12.
Bank Charges: Please Note. If a bank makes a payment, it charges a fee (bank charge). The bank charges for a transfer paid into a Maltese bank from a foreign bank can be expensive. You will have to pay these charges in addition to fees that you pay to us. You will save money if you pay the complete fees when you apply because you will pay bank charges only once. If you pay a deposit and then send the rest of the fees later, you will have to pay bank charges twice.
Note: For credit card payment you have to add a 5% supplement.
Cancellation: After you have accepted a place on a course, we cannot normally repay your deposit. If you cannot attend a course you have paid for, we can repay your fees as follows:
3 weeks before course begins fees refunded (less 20%).
2 weeks before course begins 50% refunded or (if you want) transferred to next course.
1 week before course begins no refund, but (if you want) we can transfer you to the next course.
We cannot give you a refund if you arrive late or leave early or miss part of the course. Please arrange cancellation insurance before you leave home.
Medical and Personal Insurance: Visitors to Malta are given free accident and emergency treatment in hospital (from May 2004). However, all students, especially those from countries outside the European Union, should arrange personal insurance covering accidents or longer times in hospital. We strongly advise you to take out adequate insurance for medical costs, accidents, theft, cancellation fees etc.
Make sure you have personal, cancellation and travel insurance for your stay in Malta. We cannot accept responsibility for these.
Liability: Our liability is no more than the money we have received from you. We do not accept liability for any loss, damage or misadventure you may suffer in the school, accommodation, or elsewhere.

Section 8: COURSE PAYMENT DETAILS

How do you wish to pay? (Bank Transfer or by Credit card)

For Bank Transfer payment
Banca Popolare di Fondi filiale di Formia
cin z cc 41166 abi 5296 cab 73980
B.I.C. POFOIT31007
IBAN IT30 Z052 9673 980C C007 0041 166

 

For credit card payment only

 

Please charge my Visa / MasterCard: (please give card type)

Card number:

Card Issue Date

Card Expiry Date:

Credit Card Verification Number :

Name of card holder:

Date of Birth:

Address:

E-mail:

Telephone:

Fax:

Name of Bank who issued the card:

 

Total course fee amount paid in Euros:
For credit card payment you have to add a 5% supplement. On receipt of your deposit we will send you an enrolment certificate, accommodation details if applicable, and an invoice. The balance is payable before the start of your course.

Date of arrival:

Date of Departure:

Flight No:

Time of Arrival:

Section 9: DECLARATION

- By submitting this form, I agree to accept responsibility for all fees for the course as indicated. (tuition, accommodation, transfers,excursions) and will pay them by the deadline.
- I have read, understood and accept the terms and conditions of English Plus Language Centre as shown above in section 6 of this application form.
- I understand and accept that any pictures/photos taken during any activity of English Plus Language Centre can be used for the promotion of any kind of educational activity carried out by English Plus International Company Limited.
- In case of accident or illness I give permission to any appropriate medical centre to examine or treat or make necessary referrals to outside physicians as indicated.
- I give permission to release information regarding health.
If you are under 18, you need to download our Student Enrolment Form and send to us by fax on +39 (0)770222, or by mail to:
Serapea viaggi
Via XXIV Maggio, 43
04023 Formia - Italy
Your parent or guardian must sign on your behalf. Thank you.

Serapea viaggi - Te. 0771771632 - N° verde 800 920942 - serapea@serapea.it