Online Enrolment Adults

Student
Surname
First name
Sex
M F


Date of birth

day / month / year
Nationality
Mother tongue


Address
Zip code
City
Country

Tel (private)
Tel (business)
Fax
E-Mail
Send me your news by e-mail

Course

Course centre
Number of weeks weeks
Course starting date (from Monday)
Course ending date (to Friday)
Price

Course type:








please specify
Lpw

How long have you been learning French? years

Knowledge of the language
Written :
Oral:

Please check the course start dates for total beginner
Obtained diploma(s) in French

Accomodation
 yes no
Accommodation start date
 (Sunday)
Accommodation end date
 (Saturday)
Number of weeks
weeks


Host family
Room type
 singledouble
Lunch
 halfboardbreakfast

Would you prefer a smoker family ?
 yes no it doesn't matter

Dietary requirements (vegetarian, etc.)
Do you have any health problem to mention ?
Other information we should know about?
Student's appartment
Room type
Hotel / Hostels
Room type
Lunch
Price range
 From to CHF
Transportation
Airport transfer required
Arrival airport
Arrival date
Arrival time
Flight number
Coming from
Insurances
Cancellation insurance (≈3%)
Does the student have a health insurance?
If yes, Type of insurance and name of insurance ?
Remarks
Remarks
How did you hear about ESL? (Official representative or an other)
Have you already taken part in a language course? Yes
No

An enrolment fee of CHF 110.- is added to all course prices

An extra fee of CHF 140.-for last minute visa obtaining procedure (less than 1 month before the course start)
Confirmation & send the enrollment form
We totally agree to the general conditions of ESL (without this confirmation, it's not possible to send the on-line enrollment form)
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