Application Form Student Enrolment Form Surname : First Name : Date of birth : Nationality : Gender : Male Female Address : telephone numbers : Email address : Skype address : School name and address : How long have you studied English? What is your level of English? Beginner/intermediate/advanced (A1/A2/B1/B2/C1/C2) Do you have any medical conditions? Please give details (medication taken…) Do you have any allergies? Please give details. Have you stayed away from home before? Please give details. Do you like children? Yes No Write a short description of your family/pets. What are your interests/hobbies? Signature:Parent/ Guardian :