The Linguaviva Centre Ltd.
STUDENTS CAN PRINT OUT THIS BOOKING FORM AND RETURN IT BY FAX, POST OR EMAIL
IMPORTANT EMAIL INSTRUCTIONS
PLEASE COMPLETE THE BOOKING FORM BELOW. ONCE SAVED (via Copy and Paste), IT CAN BE EMAILED TO LINGUAVIVA AS AN ATTACHMENT TO THE FOLLOWING EMAIL ADDRESS:
The
Linguaviva Centre Ltd.
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Photo here please
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BOOKING FORM:
Full
Name:
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Home
Address:
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Tel:
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E-mail
Address
Nationality:..
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Native Language:
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Profession:
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.. Level of English if known.
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How
long have you studied English?
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. Date of Birth:
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Course
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Start:
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Family Accommodation
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1 |
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(no
packed lunch) |
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2 |
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(with packed lunch) Start:
Finish:
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N.B.
Please notify your family of your exact arrival time
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Yes |
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No |
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Are
you a smoker? |
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Do
you have any special dietary |
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requirements? |
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If
yes please explain
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Airport Transfer
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No |
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Arrival |
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Departure |
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Please
enclose or forward full flight details if you require transfer/s
Signature:
Date:
Deposit
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Bank
transfer to: Bank of Ireland, Upper Leeson Street, Dublin 4 |
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Account
No: 83942780 Sort Code:
90-01-72. Enclose copy of transfer. |
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IBAN: IE76B0F190017283942780 |
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Eurodraft
drawn on any bank in Dublin. Draft will
not be accepted if drawn on a foreign bank. |
Please
email the completed form and The
Linguaviva Centre Ltd.
fax
copy of bank transfer 45
Lower Leeson Street, Dublin 2, Ireland
Tel.
353-1-6789384 or 6612106
Fax:
353-1-6765687
E-mail: enquiries@linguaviva.com