Application Form

Applicant Details

Title :

First Name :

Middle Name :

Last Name :

Date of Birth :

Gender :

MaleFemale

Nationality :

Passport No :

Passport Expiry Date :

Mobile No :

WhatsApp No :

Email :

Visa Status

Home Country Address

House No :

Street :

Postcode :

City :

Country :

UK Address

House No :

Street :

Postcode :

City:

Country :

Emergency Contact

Full Name :

Relation :

Country :

Mobile No :

Email :

Language(s) :

Course Details

Which course do you want to study? (please tick ✓)

Course Start Date :

How many weeks? :

Your English Level

What is your current English Level? (please tick ✓)

Have you taken the IELTS test? :
YesNo

If yes, please tell us your score :

Photos and Videos of Student’s Declaration

inlingua Leeds sometimes wishes to use photos or videos of students in its promotional materials and it is a condition of enrolment that students agree to their photograph / videos being used for marketing purposes including social media. However, if a student does not wish their photo or video to be used, they can opt out at any time.

YesNo

Declaration

In applying for this course, I agree to follow the Terms and Conditions of inlingua Leeds and accept the circumstances. I confirm my understanding that course fees will only be refunded in the event of a visa application refusal excluding registration fee, on production of an official Refusal of Entry Clearance letter from a British Embassy or Consulate. I also accept there will be no refund for bank holidays, public holidays or additional holidays. I agreed to read the Student Handbook and rules at inlingua Leeds.

Full Name (Printed) :

Date :

Signature :

When completed, please return to inlingua Leeds, York House, St Andrews Court, Leeds, LS3 1JY or email us at : info@inlingualeeds.com

Application Form

Applicant Details

Visa Status

Home Country Address

UK Address

Emergency Contact

Course Details

Your English Level

Special support/services requirements

Photos and Videos of Student’s Declaration

Declaration

York House, St Andrews Court, St Andrews Street, Leeds, England, LS3 1YY.

+44(0) 113 529 3249

info@inlingualeeds.com