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Direct Sales
Application form
Complete all the information requested below and return to The English Studio
programme advisor along with a copy of your passport.

Student Details
Name
Surname
Date of Birth Gender ☐ Female ☐ Male
Nationality
Passport Number/ID Passport Expiration date
Phone
Email
Current Address City
Country
Emergency Contact
Full Name
Email Mobile
City Country
School Details
Where do you want to study? ☐ London ☐ Dublin
Do you need a visa to enter the UK/Ireland? ☐ Yes ☐ No
Do you need a printed version of the Visa
☐ Yes ☐ No
Letter to be sent to you by post?
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The English Studio London can ONLY provide documents for Short Term Study Visa
I have read the Terms and Conditions
https://englishstudio.com/about-us/booking-terms-conditions ☐ Yes

Renewal Details – Ireland Only

GNIB NUMBER/ID GNIB Expiration date
(Dublin renewal only) (Dublin renewal only)

Course Details
Course type Course Timetable
Course Duration Start Date
(weeks)
Number of Hours Would you like to book
per Week Insurance? (Dublin only)
Exit Exam (Dublin only) ☐ Trinity ISE ☐ IELTS ☐ BEC ☐ CPE
Accommodation Details
Arrival Date Departure Date
Accommodation
Type
Room Type ☐ Single ☐ Twin ☐ Double
Arrival Time Arrival Flight Number
Number of weeks at
accommodation
Any Medical Special Diets?
Conditions?
 2/2

Direct Sales
Application form
Complete all the information requested below and return to The English Studio
programme advisor along with a copy of your passport.

Do you smoke? Any allergies?

*Additional details regarding your restrictions can be added to the Additional Information field at the end of this form.
Zone (if Homestay)
(London only)
Board (if Homestay)
(London only)

Please note for accommodation bookings:

Students travelling alone can NOT book homestay twin
Minimum stay accommodation 2 weeks
In Student Residences check in on Sunday and check out on Saturday

Airport transfer
Transfer requested? ☐ Yes ☐ No Airport
Arrival Time Flight Number (Arrival)
Departure Time Flight Number
(Departure)
Where did you hear about us?
Let us know where you found us, e.g. Google search or from a friend etc.

Do you have a promotion code:

7679C

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Additional Information / Special Requests

DISCLAIMER AND SIGNATURE SECTION

I hereby agree to The English Studio Terms and Conditions and Refund Policy as outlined on the website of the English Studio and
confirm that the details provided are accurate to the best of my knowledge.

DATA PROTECTION NOTICE

The English Studio will only collect and use the data you provide in this form for the purposes of registration for and performance and completion of your
course in accordance with The English Studio Privacy Notice which includes providing my data to external government bodies for regulatory and quality
control purposes. As such, The English Studio may send you emails in relation to your progress on the course and any academic issues which arise.

We would like to send you updates about our courses, services and social activities as well as special offers and news from The English Studio. To join our
mailing list, simply tick the box below

Yes, I would like to join the English Studio mailing list

You can choose to unsubscribe from our mailing list by emailing [email protected]

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Signature Date