5 August, 2001 10:42 PM
 
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Student Registration

Please ensure that the student' s details are correct.

1. NAME AND ADDRESS
Passport Number:
Title:
Last Name: " >
First Name: ">
Address 1: ">
Address 2: ">
City: ">
State/Province: " >
Country:
Zip/Postal Code: ">
Telephone Number: ">
Fax: ">
Cell/Mobile Number: ">
E-mail: ">
Gender:
Date of Birth:  
Nationality:
Country of Birth:
2. FLIGHT DETAILS
Departure Details:
Departure Airport:
Flight no: ">
Time:
Depature Date:
Transfer on Departure:
3. LANGUAGE COURSE(S)
Course Start Date Weeks
General English
Language level
4.ACCOMODATION
Package:
Accomodation:
Room Type:
Weeks:
   
Change Accomodation
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