Enrolment Form Page 1 of 5 Please complete all pages.
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STUDENT DETAILSFirst Name:.........................................................................................................................................................................................
Surname:............................................................................................................................................................................................
Nationality:...................................................................... Country: ....................................................................................................
Passport Number:.............................................Date of Birth:........................................ Age:...........................................................
Gender: Male Female  			

Address in Home Country:
Building Name / Number:..................................................................................................................................................................
Street Name:......................................................................................................................................................................................
City:.....................................................................................................................................................................................................
Post Code: .........................................................................................................................................................................................
Country:..............................................................................................................................................................................................
Telephone No:....................................................... E-mail: ................................................................................................................
Mobile No:...................................................................
Occupation: .......................................................................................................................................................................................
Do you have any Allergies / Medical Conditions, Illnesses? Yes No (if yes, please give details)................................................................................................................................................................
............................................................................................................................................................................................................
Are you taking any medication? Yes No (if yes, please give details)................................................................................................................................................................
............................................................................................................................................................................................................
Do you have any special dietary requirements? Yes No (if yes, please give details)................................................................................................................................................................
............................................................................................................................................................................................................
What level do you consider your English to be? (lowest) 1  2  3  4  5  (highest)
DOCUMENTS TO BE SENT WITH APPLICATION FORM:• Please send copy of passport • Please send any English Language Certificates 1

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COURSE DETAILSGENERAL AND EXAM ENGLISH COURSES: Starting Date: .............................
15 Hours per week  Number of Weeks..............................

Morning Afternoon 

21 Hours per week  Number of Weeks..............................
24 Hours per week  Number of Weeks..............................
30 Hours per week  Number of Weeks..............................
Additional information:......................................................................................................................................................................

NACEL E-LEARNING COURSE: Course duration: ......................................... Interface Language:.....................................................................................................
Additional information: .....................................................................................................................................................................

ONE-TO-ONE COURSE:  Total number of hours:...........................
Starting Date:...............................................................................................
Additional information:......................................................................................................................................................................

WORK EXPERIENCE OR VOLUNTEERING INTERNSHIPS (unpaid and when legally permitted): Additional information:......................................................................................................................................................................

FREE UNIVERSITY ENTRY GUIDANCE AND SUBMISSION: Additional information:......................................................................................................................................................................

PERSONALISED UNIVERSITY APPLICATION SUPPORT: 
Additional information:......................................................................................................................................................................

UNIVERSITY STUDY SKILLS: Starting Dates: ...........................................
Additional information:......................................................................................................................................................................

ENGLISH FOR SPECIFIC PURPOSES (ESP): Full Time Morning (15 hours): 2 weeks 

3 weeks 4 weeks Full Time Plus (21 hours):

3 weeks 

4 weeks 2 weeks • Medicine & Biology:

Starting Date: ............................

• Chemistry:

Starting Date: ............................

• Banking & Finance:

Starting Date: ............................

• Oil & Gas:

Starting Date: ............................

• Engineering:

Starting Date: ............................

• Executive Management & Marketing:Starting Date: ............................

• Law:Starting Date: ............................

Additional information:......................................................................................................................................................................

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Enrolment Form Page 3 of 5 Please complete all pages.
PLEASE WRITE IN BLOCK CAPITALS IN BLACK INKTEACHER TRAINING REFRESHER COURSE: Starting Date: ...........................................
Additional information:......................................................................................................................................................................

AFTERNOON CODING COURSES: TECH CAMPSGame Programming with JavaTech EntrepreneurshipPython CodingElectronics with Arduino

iOS App Development

Web development

Android Application Development with App Inventor  				Additional information:......................................................................................................................................................................

Semi-private Coding Courses: Additional information:......................................................................................................................................................................

SUMMER EXTENDED REALIA COURSE: Starting Date: ...................................................
One week: Two weeks:  Three weeks: Additional information:......................................................................................................................................................................

EXTRA CURRICULAR CLASSES: 
Professional Sports Coaching  4 Hours 

8 Hours 

10 Hours Additional information:......................................................................................................................................................................
Horse Riding Additional information:......................................................................................................................................................................
Golf  6 Hours 

10 Hours Additional information:......................................................................................................................................................................
Flower Arranging  2 hour workshop Half day extended workshop Additional information:

AIRPORT TRANSFERS: Yes  No 
Heathrow Arrival
Gatwick Arriva
Luton Arrival
Stansted Arrival
St Pancras Arrival

Heathrow Departure
Gatwick Departure
Luton Departure
Stansted Departure
St Pancras Departure

Heathrow Both Ways
Gatwick Both Ways
Luton Both Ways
Stansted Both WaysSt Pancras Both Ways

Additional passengers: Yes  No  How many?............

FLIGHT DETAILS – If known
Arrival Date:............................... Flight Number:............................Time:..................................Airport:...........................................
Departure Date: ........................ Flight Number:............................Time:..................................Airport:...........................................

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ACCOMMODATIONACCOMMODATION: Yes  No 
Number of Weeks: ............
Arrival date: .......................................

Departure date:.........................................

HOMESTAY ACCOMMODATION: Yes Half-Board - Breakfast and dinner Bed & Breakfast - Self-catering Single Room  Shared Room  Shared room is only available to students arriving and departing at the same time
En-Suite Room  An En-suite room can only be confirmed once we have received full payment and flight details
Do you have any special dietary requirements? Yes  No If YES please provide information: ...................................................................................................................................................
Do you smoke? Yes  No Please provide any information that we should be aware of when booking your homestay accommodation: .........................
............................................................................................................................................................................................................

STUDENT SHARED HOUSE: Yes ICG House: Single Room:  Single Room - En Suite:  Double Room:  Double Room - En Suite:  Twin Room - En Suite: Lady Margaret: Double Room - En Suite: RESIDENTIAL HALLS ACCOMMODATION: Yes AXO Camden: Classic Studio: The Stay Club - Kentish Town: Classic Studio:  Premium Studio: King’s Cross Residence: Bronze Studio Plus Midi Level:  Bronze Studio Plus Upper Level: Scape Shoreditch: Standard studio: LOCAL SERVICED APARTMANT: Yes One Bedroom Apartment:  Two Bedroom Apartment: Number Of Adult(s): ………… / Number Of Children: ………. Age: ……….
Additional information: .....................................................................................................................................................................

LOCAL GUEST HOUSE / HOTEL ACCOMMODATION: Yes Double Room En-Suite for 1 person occupancy:  Double Room En-Suite for 2 people occupancy : Twin Room En-Suite for 2 people occupancy: Triple Room En-Suite for 3 people occupancy: Additional information: .....................................................................................................................................................................

ALTERNATIVE ACCOMMODATION: Yes If you require any other type of accommodation
Please specify: ..................................................................................................................................................................................
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STUDENTGUARD+ Student Travel Insurance: Yes  No Please tick the YES box if you would like to take out Studentguard+ Student Travel Insurance for £5.54 per week.

Please see our website for details of cover.
Number of weeks (please include the full period of your stay in the UK):.....................................................................................
Policy start date: ........................................................................ Policy end date: ........................................................................
Date you travel to UK

Date you travel home

Additional information: .....................................................................................................................................................................
The policy will only be booked on your behalf once we receive full payment and your completearrival and departure flight details.

HOW DID YOU HEAR OF NACEL ENGLISH SCHOOL LONDON?
A friend  Google  Press Article  English UK  British Council  Outside Signage Agent  Name of the Agency:.......................................................................................................................................................
Other  Please specify:.................................................................................................................................................................

DO YOU NEED A VISA TO ENTER THE UK?
Yes  No If yes, which visa are you applying for?
Student Visa (Requiring a CAS) 
Short-term Study Visa (STS) 6 – 11months Standard Visitor Visa 6 months 

Applying for VisaNacel English School London is a certified UKVI Student Sponsor within the Migrants Points Based System(PBS).
SPONSOR’S LICENSE NUMBER (SLN): 7HV8QVGK4
If you are applying for a Student visa you will need a confirmation of Acceptance of Studies(CAS) from the School. The
cost is £45 and will be added to your invoice (including Online interview with teacher).

I WOULD LIKE TO RECEIVE MY LETTERS OF ENROLMENT BY:e-mail (PDF)  Post  Courier (DHL/FedEx) £48 I agree to attend the above course requested and supply the school with a medical certificate if I am ill or have a valid andsupported reason to be absent. I understand my name may be struck from the register if I fail to meet these requirements.
I also understand that the fees are not REFUNDABLE OR TRANSFERABLE under any CIRCUMSTANCES and have read,understood and agree to Nacel English School London conditions of enrolment.
Name..................................................................................................................................................................................................
(BLOCK CAPITALS)
Signed.................................................................................................................................................................................................
(if under 18, parent or guardian must sign)
Date.....................................................................................................................................................................................................
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