Family Name
First Name:
Address:
Telephone number:
Fax number:
Email address:
Occupation
Nationality:
Passport Number:
Date Of Birth
Gender
Male
Female
My level of English is

Beginner
Elementary
Intermediate
Upper Intermediate
Advanced

English Exams Taken
Please check the courses required: English Courses
A registration fee of £50.00 is payable for all courses, except the IELTS week and Cambridge exam course.
Intensive English 23.5 hours per week
1 to 11 weeks
12 to 23 weeks
24+ weeks
Intensive English 17.5 hours per week
1 to 11 weeks
12 to 23 weeks
24+ weeks
IELTS Preparation
The IELTS Week
6 Week IELTS Preparation
Special Group Courses
Price on application
English Country Gardens
Specialist closed group courses
Cambridge Exam Courses
Individual Tuition
£42.50 per hour
Length Of Course
Course start date Day Month Year
Course end date Day Month Year
Accommodation and Welfare
Please tick the type of accommodation you would prefer
Homestay accommodation, to include bed, breakfast and evening meal seven days a week. £105.00 per week
Guest House or Inn, to include bed and breakfast, From £50.00 per night
Hotel, to include bed and breakfast. From £70.00 per night
None of the above
Arrival Date Day Month Year
Departure Date Day Month Year
Do you smoke? Yes
No
Do you have any special requirements?
Do you have any health or medical problems?
Do you have any special dietary requirements?
Do you have any allergies?
Airport transfer
Do you need collection from the airport? Please give details:
Arrival Airport
Flight Number
Arrival Date
Arrival Time
Departure Airport
Flight Number
Departure Date
Departure Time
Deposit

I am sending the deposit of to Harrogate Language Academy's bank by:
Bank Transfer (Please add £15.00 to cover UK bank charges on transfers)
Cheque (Cheques must be in Pounds Sterling drawn on a UK bank, showing the Bank's address & sort-code. Cheques are to be made payable to Harrogate Language Academy and should be sent to: Harrogate Language Academy, 8a Royal Parade, Harrogate, HG1 2SZ, UK.)
If you are paying by bank transfer, please e-mail us details of the payment when you make it to: studentservices@hla.co.uk

Our bank details are

Bank Royal Bank of Scotland
Bank address 7 Cambridge Street
Harrogate
HG1 1PH
United Kingdom
Account Name Harrogate Language Academy
Account Number 10153230
Sort Code 16-20-36
IBAN Number GB83RBOS16203610153230
IBAN BIC RBOSGB2L
Booking Conditions

In these conditions “You” means the student or the student’s guardian and “We“ means Harrogate Language Academy Ltd.
1 Registration: When booking you must pay the deposit of £250. The balance of your fees and charges must be paid no later than three weeks before your course starts.
Students are not allowed to attend classes or to remain in accommodation unless payment has been received in full before the start of the course.
2 Payment: Payment must be made in pounds sterling.
3 Cancellation before you arrive: You must return your certificate of enrolment and inform us in writing three weeks before the start of your course. We will refund everything you have paid to us – except the deposit.
4 Cancellation after you arrive: You must return your certificate of enrolment. There will be no refund of tuition fees. You will need to