Dublin Summer School Booking Form

About You... SURNAME FIRST NAME(S) AGE NATIONALITY GENDER male female Your Contact Details... HOUSE NAME/NUMBER STREET TOWN POSTCODE TELEPHONE E-MAIL Your Course Requirements... IN DUBLIN FROM   until   Please note: our programmes run in July & August KNOWLEDGE OF ENGLISH beginner lower intermediate intermediate higher intermediate advanced WITH ACCOMMODATION Yes, please organize family accommodation for me No thank you TYPE OF PROGRAM English Language Programme for young people (12-20 years) General English Language Programme for Adults (21+ years) Commercial English Course for Secretaries and Office Staff Teacher Refresher Course for non-native Teachers DO YOU NEED AIRPORT TRANSFER IN DUBLIN Yes No (EUR 45.-/Transfer) HOW DID YOU HEAR ABOUT US? From a friend Through school Through an Internet search engine I have attended one of your courses before Through a local advertisement By a recommendation none of the above TODAYS DATE

IMPORTANT NOTICE: When we have received your booking form we will confirm your place and tell you how to go about paying for the programme.