Student Works Application Form

Your contact details

Full Name *

First Name Last Name

Nationality *

Phone Number

- Area Code Phone Number

Date of Birth

- Day - Month Year

Sex

Male Female

E-mail *

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Passport Number or ID card Number

Accommodation

Do you need an accommodation?

Yes No I am not sure yet

If yes/maybe: what room size would you like ?

Single Twin Double

En-suite

Yes No

Check-in date

- Day - Month Year

Check-out date

- Day - Month Year

How much do you want to spend per week (£ or Euros)

Do you prefer:

Host family House/flat share

If you want a host family, do you prefer:

Room only Half-board Full-board

Do you have any allergies, or dietary needs or anything else we should know?

Work experience program

Are you looking for a work experience?

Yes No I am not sure yet

If yes/maybe: are you interested in a paid or unpaid work program

Paid Unpaid Indifferent AU PAIR

What industry do you wish to work in?

Start date

- Day - Month Year

End date

- Day - Month Year

Are you applying for a scholarship (i.e. Leonardo or Erasmus)

Your CV (for work programs only)

English course program

Do you need an English course?

Yes No I am not sure yet

If yes/maybe: what type of course

General English to include part time, full time or intensive Cambridge exams to include FCE/CAE IELTS Business SPECIALIST COURSE

Start date

- Day - Month Year

End date

- Day - Month Year

Location in the UK OR IRELAND you would like to go to

Current level of English

Elementary Low Intrmediate Intermediate Upper Intermediate Advanced I don't know - send me a test!

How much do you want to spend per week?

How many hours per week do you want?

What time can you do the lessons? Also how many weeks do you want?

Transfer in the UK

Do you require a transfer from a UK airport?

Yes No

How did you hear about us?

I give permission for my details to be shared with 3rd parties such as schools or businesses that are relevant to my file.

Yes No