Student Request Booking Form - Malvern House Brighton

Name*

First name as per passport Surname as per passport

Gender

Date of Birth*

Nationality 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 ?*

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*

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?*

What times can you study?*

Please mark as many options as possible.

Other

Do you want Accommodation?*

Yes
No

Accommodation Type*

Homestay
Residence

Homestay Type*

Homestay Option*

Residence Type*

Accommodation start date*

Accommodation end date*

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?*

If you are travelling to the UK for your course, please complete your travel details below.

Airline

Flight number

Arrival date

Arrival airport*

Arrival Time

Arrival Time (minutes)

Departure date

Departure airport

Departure Time

Departure Time (minutes)

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

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