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Application Form

Personal Details

First Name:
Last Name:
Date of Birth:
Gender:
MaleFemale
Nationality:
Passport/ID number:
Address in your country:
Address in London:
Phone number:
UK Phone number:
E-mail:

Emergency Contact Details

Full Name:
Relationship to you:
Do they speak English?:
YesNo
Mother tongue (language spoken at home):
Email address:
Phone number:

Course Details

Course name:
Course starting date:
Number of weeks:
English level:

Accommodation

Not requiredHomestayResidence
Arrival date:
Departure date:
Weeks:
Zone:
1234
Room type:
SingleTwinDouble

Homestay

Meal plan:
Bed&BreakfastHalf-Board
Preferences:
No CatsNo DogsVegetarianVeganGluten free
Allergies / Special requests:

Residence

Preferred facilities: Studio (private bathroom and kitchen)En-suite (private bathroom)Single room (room only)
First choice residence:
Second choice residence:

Transfer

Not requiredOne-wayReturn

Arrival

Date of arrival:
Time of arrival:
Airport:
Flight Number:

Departure

Date of departure:
Time of departure:
Airport:
Flight Number:

Visa

Do you need to apply for visa?
YesNo
If yes, what type of visa are you applying for?
Have you previously been refused a visa or entry into the UK?
YesNo
If yes, please give details:

Reasons for studying English

Why did you decide to enrol on an English course?
WorkStudiesTravelOther
Why have you chosen to study in the UK?
Why have you chosen to study at Rose of York Language School?
What do you plan to do when you finish your course?

Previous study history

Please provide details of your previous studies in English:
High SchoolUniversity / CollegeLanguage School in your countryLanguage School in UK / other country
Have you taken an official English Examination?
YesNo
If yes, please give details:

Additional information

How did you hear about Rose of York?

Payment

Courses and accommodation can only be confirmed once full payment has been received.
Please choose your preferred method of payment:
Bank transferCredit/Debit CardOnlineCash
We advise that you take out insurance for your own security. You can take out your own insurance or the ones offered by either Endsleigh International Student Insurance or the International Student Policy offered by Guard.me. Students from the EU should bring their European Health Insurance Card.
Students under 18 must take out insurance and send proof to the school before departure.