Application/Registration

Name:
Email Address:
Fax Number
Telephone Number
Country
Native Language
Mailing Address




Gender

Male Female

Birth Date
MM DD YYYY

Please click on the language level category that most closely represents your English level.
zero level (no previous English learning)
Beginning
Intermediate
Advanced

Please click on the type of study requested:
Individual
Group of Two
Group of Three

Study Sessions: Please list 3 preferred sessions See Course Openings
Session #1
Session #2
Session #3

Name of Study Group Members (if applicable):

1.

2.

3.

Please note: all study group members must submit separate application/registration forms.

Hobbies/Specials Interests:

1.

2.

3.

Allergies/Special Needs:

1.

2.

3.

 

Please attach a Certificate of Financial Responsibility (bank statement) showing you or your sponsor has sufficient funds to support your studies at The Learning Park and proof of health insurance in a separate email after submitting your application. Send the email and attachments to: application@thelearningpark.com.

Upon acceptance, a Needs Analysis Form and English Background Form will be emailed to you. Please return the forms within seven (7) days, along with a 20% non-refundable deposit. Bank information for wiring deposit and program fees will be provided upon application approval.

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