Junior Summer Centre Application Form

Junior Summer Centre Application Form
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal Code
Nationality*
Other Nationality
Email*
example@example.com
Telephone/Mobile*

Area CodePhone Number
Arrival Date

MonthDayYear
Date
Flight Number
Arrival Time
Departure Date

MonthDayYear
Date
Flight Number
Departure Time
Accommodation*
Total number of weeks you wish to book:*
Please specify accommodation
Please indicate airport transfer service required?*
Please note the Airport Transfer is compulsory for unaccompanied students under 18 years of age.
Have you studied English before?
Please indicate how many years you have studied English
English Level
*Beginner classes subject to availability.
Have you taken any English exams?
Please give details of exams taken

Approximate total for course:€
Please note that the total cost covers full board accommodation on a sharing basis.
If you have not chosen 'Homestay' as the accommodation option, please contact PACE for an estimated total cost for the course
Please Note:
- All fees are payable in advance (plus €10 if paying by bank transfer). Administration fee is not refundable.
- All bookings are subject to our Terms and Conditions. Please contact info@paceinstitute.ie for more details.
- No refunds are given for non-arrivals, late arrivals, early departure or absence from any classes or activities, for any reason.
- Although PACE will endeavour to fulfil your chosen options for morning and afternoon activities, this may not always be possible. You will be informed of any changes to your timetable before the course start date.
- Providing and holding personal information comes with significant rights on your part and significant responsibilities on ours. At PACE, we take your privacy seriously and are fully committed to keeping your information private. It is important that you know exactly what we do with the personal information that you and others provide to us, why we gather it and what it means to you.
  Please click here to view our Data Protection Policy
I agree to the Terms and Conditions of PACE Junior Summer Centre (Bray)*

.
Please verify that you are human*
Should be Empty:

Course Options (sports options will incur an extra cost)