Mon - Fri 8:30 AM – 5:30 PM
20 Queens Road, Brighton, BN1 3XA, UK
+44 (0)1273 661575 | WhatsApp +44 7882 578310
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MENU
MENU
Home
Why Us?
About Us
Our Team
Teachers & Support Team
Operations Team
Sister Schools
2023 Factsheet
Care of under 18s
Blog
Policies
Image Gallery
Student Life
Useful Information
Student Testimonials
Social Programme
Accommodation
Homestay
Student Residence
Courses
General English
Business English
IELTS Preparation
Cambridge Preparation
VIP English
Part Time & Evening English
Prices
Apply Now!
Schedule Appointment
Apply Now
Visas
Payment
Level Test
Contact Us
Contact Details
Become a Host
2023 Brochure
All Schools Brochure 2023
Malvern House Brighton
>
Student Request Booking Form
Student Request Booking Form
Name
*
First name as per passport
Surname as per passport
Gender
- Select Gender -
Male
Female
Prefer not to say
Date of Birth
*
DD slash MM slash YYYY
Nationality Country
*
- Select Country -
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
What is your first language?
*
Address
*
City
*
Email Address
*
Mobile Number
*
Are you using a Booking Agent?
*
Yes
No
Agent Name
*
Emergency Contact Person (Relative/Friend)
Name
Relationship to You
Phone Number
Email Address
Full Time or Part Time
*
Full Time
Part Time
How many hours do you want to study a week?
*
15 hours per week
20 hours per week
25 hours per week
30 hours per week
Which course are you interested in ?
*
--
General English
General English with extra Conversation
Business English
IELTS Exam Preparation
Cambridge Exam Preparation
English Plus
Business English
English for Conversation
English for British Culture
VIP English
Do you need a visa support letter?
*
Yes
No
Please upload your passport copy
*
Accepted file types: jpg, png, pdf, gif, Max. file size: 4 MB.
How many hours do you want to study a week?
*
5 hours per week
7.5 hours per week
12.5 hours per week
Other
Other
Course start date
*
DD slash MM slash YYYY
How many weeks will you study?
*
Please enter a number from 1 to 44.
How many weeks will you study?
*
Please enter a number from 4 to 44.
When can you study?
*
--
Morning
Afternoon
I don't mind
What times can you study?
*
Please mark as many options as possible.
9:00 - 11:30
12:00 - 14:30
15:00 - 17:30
18:00 - 20:00
Other
Other
Do you want Accommodation?
*
Yes
No
Accommodation Type
*
Homestay
Residence
Homestay Type
*
--
Standard
Superior
Standard with private bathroom
Superior with private bathroom
Homestay Option
*
--
Single room with breakfast and dinner
Single room with breakfast only
Single room, self-catering
Twin room
Residence Type
*
--
Britannia Study Hotel
Others
Accommodation start date
*
DD slash MM slash YYYY
Accommodation end date
*
MM slash DD slash YYYY
How many weeks and days in total?
*
In order for us to best support you while you are with us, please let us know about any
Mental health conditions
Any learning difficulties
Any physical difficulties
None of above
please specify any mental health conditions
please specify learning difficulties
please specify physical difficulties
Do you want to book a transfer between the airport and accommodation?
*
--
No Transfer Required
Arrival Only
Arrival & Departure
If you are travelling to the UK for your course, please complete your travel details below.
Airline
Flight number
Arrival date
DD slash MM slash YYYY
Arrival airport
*
Arrival Time
--
00:00
01:00
02:00
03:00
04:00
05:00
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
Arrival Time (minutes)
--
00:00
00:15
00:30
00:45
Departure date
DD slash MM slash YYYY
Departure airport
Departure Time
--
00:00
01:00
02:00
03:00
04:00
05:00
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
Departure Time (minutes)
--
00:00
00:15
00:30
00:45
Students are entitled to a one week holiday for every 12 weeks of study. If you are joining for less than 12 weeks, you are not entitled to extra class time free of charge, unless you let us know now. If you have any holiday booked please put the dates below.
Do you have any specific requests for flexible study ? Please state:
*
Comments / special requests:
If you’d like to use the Early Bird offer, please put the date when you plan to make the payment
*Terms & Conditions are available HERE
*
I confirm that I have read a copy of the Terms and Conditions. I agree to abide by these Malvern House Rules. *
*Terms & Conditions are available
HERE
We process personal information to enable us to: provide education, training and educational support services such as accommodation and travel to our clients. It is also necessary for us to ensure the Safeguarding of our students and maintain student welfare. In addition, this information is required for us to administer our school's property, maintain our own accounts and records and to support and manage our employees. Data is held, used and ultimately destroyed in strict accordance with The
General Data Protection Regulation
(GDPR) (EU) 2016/679. The full data protection policy can be found
HERE
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