Instructions for filling in your Application Form
You have the choice of filling out the application form either online, below, or printing out the form and faxing it or posting it to us (details of where to send it can be found at the bottom of the form). Click here to download the application form in Adobe Acrobat (PDF) format so that you can print it and send it to us by fax or post (right-click and 'save target as' to download). Please ensure that all relevant sections are completed.
Once we have received your application, we will contact you shortly with a detailed Course Proposal.


Date:
 
Personal Details
Mr  Miss  Mrs  Ms
First name: Family name:
Nationality: First language(s):
Date of birth: Occupation:
Address in your country:
 Postcode:
Email:
Phone:
Fax:
Address in UK (if known):
 Postcode:
Phone:
Mobile:
Fax:
Is your company paying for your course?   Yes  No   If Yes, please complete with your company details:
Company name: Your position in company:
Company address:
 Postcode:
Name of contact:
Phone:
Fax:
Email:
 
Your English
How did you hear about One to One English?
Web  Friend  Agent    Publication:    Other 
Have you taken a course before at One to One English?  Yes  No   If Yes, when?:
What is your present level of English?
  Beginner: I don't speak or understand any English
Elementary: I can say a few basic things and understand short, simple conversations
Early intermediate: I can understand simple conversations, and can speak a little (with mistakes) on
most everyday topics
Intermediate: I can speak quite well on most topics, and understand the general sense of most
everyday conversations
Upper intermediate: I still make some mistakes, but I can speak quite quickly and confidently on
most topics
Advanced: I can understand even complex topics, and speak fluently with few mistakes
Have you taken any of the following exams?
If Yes, please state when you took these examinations and the grade/score achieved
Cambridge KET Cambridge CPE
Cambridge PET IELTS (Academic/General)
Cambridge FCE TOEFL
Cambridge CAE TOEIC
Other (please give full details)
Have you studied English in the UK, or in another English-speaking country, in the last three years?   Yes  No
 
Dates:
Type of course:
Level:
Are you studying English now in your country?   Yes  No
 
Type of course:
Level:
 
Course Application
Please choose ONE only from the following list of courses. If you would like to apply for more than one type of course, please complete a new application form for each course. If you are not sure which course is best for you, please contact us for help. Please click here for full terms and conditions of booking.

3-1 FULL-TIME COURSES
3-1 Full-Time General English
Basic (15 hours per week)
PLUS-2 (two extra 1-1 lessons per week)
PLUS-3 (three extra 1-1 lessons per week)
PLUS-5 (five extra 1-1 lessons per week)
PLUS-10 (ten extra 1-1 lessons per week) 		3-1 Full-Time Examination Courses
IELTS (Academic Module)
First Certificate in English
Certificate in Advanced English
Start: (dd/mm/yy)
Number of weeks:

1-1 FULL-TIME COURSES
1-1 Full-Time General English
1-1 Full-Time English for Professionals
1-1 Full-Time English for Special Purposes 		1-1 Full-Time Examination Courses
IELTS (Academic Module)
IELTS (General Training Module)
Key English Test
Preliminary English Test
First Certificate in English
Certificate in Advanced English
Certificate of Proficiency in English
Start: (dd/mm/yy)
Number of weeks:
10, 15 or 20 lessons per week:
Preferred timetable:

3-1 PART-TIME COURSES
3-1 Part-Time General English
3-1 Part-Time First Certificate in English
3-1 Part-Time Certificate in Advanced English
3-1 Part-Time IELTS (Academic Module)
Start: (dd/mm/yy)
Number of weeks:

1-1 FLEXI-TIME COURSES
1-1 Flexi-Time General English
1-1 Flexi-Time English for Professionals
1-1 Flexi-Time English for Special Purposes 		1-1 Flexi-Time Examination Courses
IELTS (Academic Module)
IELTS (General Training Module)
Key English Test
Preliminary English Test
First Certificate in English
Certificate in Advanced English
Certificate of Proficiency in English
Start: (dd/mm/yy)
Number of weeks:
Lessons per week:
Preferred timetable:
 
Accommodation
I would like to book accommodation for weeks, from (dd/mm/yy) to (dd/mm/yy)
Accommodation type:
1st choice:   2nd choice:
It is usually possible to arrange your first choice of accommodation. However, in particularly busy periods we may offer you accommodation of your second choice.
Meal option:   Breakfast  Breakfast and Dinner  Self-Catering
Do you require an ensuite bathroom? (Gold and Silver homestay only)   Yes No
Would you like single or twin room accommodation? If you have chosen to share accommodation (Twin room), please enter the full name of the person with whom you will be sharing.
Single Twin
Do you smoke?   Yes No
If Yes, smoking accommodation may be limited. Will you accept non-smoking accommodation, and only smoke outside your accommodation?   Yes No
Do you have any special dietary requirements (e.g. vegetarian)?   Yes No
If Yes, please give details:
Do you have any allergies or strong dislikes (e.g. to animals)?   Yes No
If Yes, please give details:
Do you have any other special requirements?   Yes No
If Yes, please give details:
 
Airport Transfer
Do you require an airport transfer?   Yes No

If Yes, please complete the following details:
Airport:
Heathrow (£70.00) Gatwick (£90.00) Stansted (£90.00)
Other (contact us for other available airports)
Date of arrival: (dd/mm/yy)Flight number:
Time of arrival: (e.g. 18:30) Airline:
Arriving from:
 
Payment Details
If you wish, you may calculate here the cost of your programme. However, we will contact you shortly to check your booking details, to confirm the cost of your programme, and to request payment.
PLEASE DO NOT MAKE ANY PAYMENT NOW.

Registration fee (£42):£
Course fees:£
Accommodation arrangement fee (£42):£
Accommodation fee:£
Airport transfer fee:£

Other fees*
Fee details: Cost:£
Fee details: Cost:£

TOTAL COST:		£

* Other fees: for example, Gold / Silver Homestay accommodation ensuite supplements; the cost of coursebooks for General English courses; bank transfer supplement.

Payment Methods

How will you be paying for your programme?
Bank transfer
Credit card
Sterling cheque
Cash


Bank transfer
Barclays Bank PLC
Islington Branch
PO Box 3474, London NW1 7NG
Account name: One to One English Ltd
Account no: 00000019 Sort code: 20-44-86
IBAN no: IBAN GB19 BARC2044 8600 000019
Swift BIC: BARCGB22

Please note that a bank transfer supplement of £15.00 must be added to cover bank charges

Credit card
For credit card payments, please add 3% to the total cost of your programme.

When we request payment, please tell us your credit card details by fax only. To do this, please download and print the credit card payment section of this application form, complete with your details, and fax it to the school on +44 (0)20 7379 1888.

Sterling cheque
Please make cheque payable to: One to One English Ltd.
Cheques must be in GBP and drawn on a UK-based bank.

Cash
In person only. Please do not send cash by post.
 
Sending your application
After ensuring that you have completed all relevant sections and that you have read and accept the Terms and Conditions, please submit your application form. We will contact you shortly to confirm your booking.

I have read and accept the terms and conditions and confirm that the details I have provided are correct.

Your name, if you are NOT the student:

Relationship to the student (e.g. parent / guardian / etc.):