EFL: UK Direct Booking Form

Name*

First NameLast Name

Email*

Confirmation EmailPlease Confirm Email

Mobile Number*

Date of Birth (16+)*

Date

Which country/region do you live in?*

Are you a Canadian citizen or permanent resident?*

YesNo

Do you need an I-20 in order to study in the US?*

Yes (I-20 re-issue fee: $75)No

Submission date

Date

Hour Minutes

How did you hear about us?

Course Delivery Location*

Course*

Morning 20 - 20x45min General English Lessons

Intensive 30 - 20x45min General English Lessons + 10x45min Elective Lessons

Super Intensive 40 - 20x45min General English lessons + 20x45min Elective lessons

*Subject to availability based on minimum numbers and suitable level

IELTS 20 - 20x45min IELTS Exam Preparation

*Subject to availability based on minimum numbers and suitable level

Number of Weeks*

Number of weeks (for calculation)*

GCLID*

fbclid*

TTCLID*

utm_campaign*

utm_term*

utm_medium*

Course Start Date*

Date

Please select the number of weeks you would like to buy the insurance for*

By purchasing the insurance, you agree to the terms and conditions. Please also note that insurance is non-refundable once purchased

Would you like to include the IELTS Preparation Course? Select the IELTS Prep Course you would like to add:

IELTS Prep CourseIELTS Prep Course plus Official IELTS Exam

Would you like additional electives? Select the course(s) you would like to add:

Elective A - Confident Speaking (5 hours)Elective B - Business English (4 hours)Elective C - Academic Skills (9 hours)

Course material fee*

I understand and accept the additional course materials fee of £75

Students under 18 must also have a completed Parental Consent Form when applying. No course or programme shall be organised until Parental Consent has been granted. Email languageadmissions@oxfordinternational.com for more information.

Please choose a payment option*

I want to pay the full amountI want to pay 20% deposit now

Base rate (for calculation)*

Gross total 1 (used for calculation)*

Gross total 2 (used for calculation)*

Actual total due (used for make)*

course fee x no.of weeks+ material course fee

Promocode

Final Due (for calculation)*

Final Due*

By proceeding you consent to have read and agree to the Terms and Conditions on the tariff brochure*

I Agree