Carraig Linguistic Services - Booking Form

Student Details

First Name: __________________________________________________________________________

Family Name: ________________________________________________________________________

Male/Female: _________________________    Date of Birth: __________________________________

Native Language: _______________________________

Nationality: ___________________________

Home Address: _______________________________________________________________________

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Student Mobile Number: ________________________________________________________________

Have you been on a Summer Course with Carraig Linguistic Servives previously? ___________________

 

 

Parent/Guardian Details

First Name: __________________________________________________________________________

Family Name: ________________________________________________________________________

Home Address: _______________________________________________________________________

____________________________________________________________________________________

Contact Telephone Number: _____________________________________________________________

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E mail address: _______________________________________________________________________

Relationship to student: _________________________________________________________________

 

 

Agent's Details

Company Name: _______________________________________________________________________

Address: ______________________________________________________________________________

______________________________________________________________________________________

Contact Name: __________________________________________________________________________

Contact Telephone Numbers: _______________________________________________________________

E mail address: __________________________________________________________________________


 

Please tick which Course you are booking:

English & General Activities _________

English & Horse Riding _____________

English & Golf _____________________

English & Sailing ___________________

 

 

Course Dates:

Arrival Date: ___________________________________________  Departure Date: ______________________________________

Number of Students: _____________________________________

 

 

Payment Details

Payment must be made by bank transfer for the group with all charges being paid for by the Agent.


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