Summer School Application Form for Brooke House College 2017

Summer School Application Form for Brooke House College 2017 Summer School 2017 www.brookehousecollege.co.uk/summerschool ARRIVAL AND DEPARTURE DETAILS Arrival date: Departure Date: Do you require a transfer? YES NO (Flight details may be sent later, once the ticket is booked) ARRIVAL Flight Number: of Arrival: Airport: DEPARTURE Flight Number: of Arrival: Airport: STUDENT DETAILS Surname: Date of Birth: Nationality: First name: Male or Female: Passport number: Student email address: Do you require a visa to travel to UK? YES NO Do you have any special medical conditions or requirements? Please give details below: Do you have any special dietary requirements? Please give details below: How did you hear about the Brooke House College Summer School? AGENT / REPRESENTATIVE DETAILS If you have been referred to us through an agent or representative, please provide us with full details. Agent/Representative Company: Email: Agent/Representative contact name: Telephone number: FAMILY DETAILS This will be the address used to post GESE or IELTS certificates. Please write clearly. Father s name: Mother s name: Home address*: Telephone: (Home) Telephone: (Business) Telephone: (Mobile)* Email: *required for DHL delivery of certificates 1

COURSE AND ACCOMMODATION DETAILS STUDENT NAME For which course would you like to register? Please tick. (If selecting a combination of two or more courses, please indicate dates of each course on this form.) English Plus Activities English Plus British Culture IELTS Preparation English Plus (16th-30th July only) English Plus GCSE / A-level Taster English Plus Riding English Plus (30th July-27th August only) English Plus (16th - 30th July only) IELTS Preparation Additional Information Students on the IELTS Preparation course will be entered for an IELTS examination in Cambridge taking place on Saturday 29th July and 12th & 26th August. The cost of the examination, including transport to Cambridge, is 180.00. If you have registered for the IELTS Preparation course, please tick yes or no below to indicate whether or not you wish to be entered for the examination. YES NO Which type of accommodation would you prefer? Please tick one. Please note that homestay accommodation is extremely limited and allocated on a first-come first-served basis for students aged 16 years and over only. Campus accommodation Homestay ENGLISH LANGUAGE LEVEL Number of years studying English If applicable, previous GESE / IELTS (*delete as appropriate): Grade Achieved Date of certification Current level of English (please tick one): Elementary Pre-Intermediate Intermediate Upper-Intermediate Advanced WEST END MUSICAL* (Optional Addition) Evening visit to a West End Musical including a pre-theatre dinner and transport by train to London. An additional charge of 100.00 will be applied. I would like to visit a West End Musical (please tick): YES NO *Musicals visited during Summer School 2016 were Charlie and the Chocolate Factory, Mathilda and Wicked. DECLARATION DEPOSIT (Included in the Course Fees) I enclose a cheque payable to Brooke House College for the sum of 200/ I am transferring to Brooke House College the sum of 200. I am aware of all terms and conditions. Parent/Guardian Signature Print Name Date 2

SAMPLE SCHEDULE - 15 HOURS OF LESSONS WEEK 1 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:15 10:45 English Graded English Speaking Exam (GESE) Course 11:00 12:30 English Graded English Speaking Exam (GESE) Course Market Harborough Orientation Harry Potter Studio Tour Swimming Raft Building London Sightseeing - Boat Trip, Walking Tour & (Oxford Street) Alton Towers Theme Park Wacky Races Mug Painting Capture the Flag Cookie Making Volleyball Field Games Harry Potter Movie Nail Painting Table Tournament Neon 22:30 Bed WEEK 2 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:15 10:45 English Graded English Speaking Exam (GESE) Course 11:00 12:30 English Graded English Speaking Exam (GESE) Course GESE Speaking Test GESE Speaking Test Ice Skating Shakespeare s House & Stratford Upon Avon Swimming Leicester Shopping Cambridge & Punting Depart Staff vs Students Jenga Tournament Dodgeball Loom Bands Nukemball Crazy Challenges Danish Longball Hot Cross Buns Karaoke Zumba Silent 22:30 Bed 3

SAMPLE SCHEDULE - 27 HOURS OF LESSONS WEEK 1 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:15 10:45 English Graded English Speaking Exam (GESE) Course IELTS Course 11:00 12:30 English Graded English Speaking Exam (GESE) Course IELTS Course Harry Potter Studio Tour London Sightseeing - Boat Trip, Walking Tour & (Oxford Street) Alton Towers Theme Park Wacky Races Bag Painting Capture the Flag Cookie Making Volleyball Field Games Harry Potter Movie Nail Painting Table Tournament Neon 22:30 Bed WEEK 2 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:15 10:45 English Graded English Speaking Exam (GESE) Course (Exam on Friday) IELTS Course 11:00 12:30 English Graded English Speaking Exam (GESE) Course (Exam on Friday) IELTS Course Harry Potter Studio Tour Cambridge & Punting IELTS Exam Depart Staff vs Students Darts Tournament Dodgeball Loom Bands Nukemball Crazy Challenges Danish Longball Hot Cross Buns Karaoke Zumba Silent 22:30 Bed 4

DATES & FEES SUMMER SCHOOL STARTS Sunday 2nd July 2017 SUMMER SCHOOL ENDS Sunday 27th August 2017 LENGTH OF STAY The minimum length of stay is 2 weeks. The maximum stay is 8 weeks. WEEKLY FEES 2nd July-13th Aug 13th Aug-27th Aug COURSE Campus Homestay Campus Homestay English Plus Activities 840 960 790 910 15 Hours of English 27 Hours of English English Plus Riding 1,000 1,120 950 1,070 English Plus (16th July - 30th July 2017) 950 1,070 English Plus (16th July - 30th July 2017) 1,065 1,185 English Plus (30th July - 27th August 2017) 860 980 810 930 English Plus British Culture 885 1,005 835 955 English Plus GCSE Taster 885 1,005 835 955 English Plus A Level Taster 885 1,005 835 955 IELTS Preparation (One off optional IELTS examination 180.00) 905 1,025 855 975 WEST END MUSICAL: An additional charge of 100 will be applied for students that register to join the optional evening visit to a West End Musical. The visit includes a pre-theatre dinner and transport to London by train. RETURN AIRPT & EUROSTAR CHARGES London Heathrow Airport: 250.00 London Stansted & Luton Airport: 220.00 London Gatwick Airport: 280.00 Birmingham & East Midlands Airport: 140.00 London St Pancras (Eurostar): 105.00 UNACCOMPANIED MIN CHARGE An extra charge of 50.00 will be applied where a student is registered on an unaccompanied minor service. This charge covers the requirement of airline policies to remain at the airport until the flight has taken off. COURIER CHARGES An extra charge of 15.00 will be applied where registration documents are sent by courier. DETAILS F DIRECT BANK TRANSFER Account name: Brooke House College Address: Yorkshire Bank plc, 29 Horsefair Street, Leicester LE1 5BL, UK Account Number: 29639024 Sort Code: 05-05-60 Account reference: IBAN: GB56 YK 05056029 6390 24 BIC: YKGB21560 DETAILS F CREDIT CARD PAYMENTS Telephone number: +44 1858 462 452 Ask for the Summer School Department Charges: Personal Debit Card 0.73% Personal Credit Card 1.54% Business Credit Card (Mastercard/Visa) 2.05% Business Credit Card (JCB/Diners) 2.25% 5

TERMS & CONDITIONS Deposit and Payment: The deposit is included in the total fees. This amount is 100% non-refundable except where a student fails in his application for a UK visa. Full fees payment is due four weeks before the beginning of the course. Cancellations: Fees (minus the deposit) are fully refundable in the case of cancellations made outside of the period 4 weeks before the beginning of the course. Fees are non-refundable in case of cancellations made within 4 weeks of the beginning of the course except where a student fails to obtain a visa. Refunds may be made at the discretion of the College in the event of serious illness, accident or death relating to the student or close family member before the start of or during the course. Liability: It shall be a condition of the contract between the parties that Brooke House College shall not be in any way liable for services contracted to supply where those services become impossible to supply owing to reasons beyond the control of Brooke House College. Course Changes: Brooke House College reserves the right to cancel or amend courses. In the event that the course for which a student has enrolled is cancelled then that student will be placed on an alternative course and/or offered a refund of all course fees. Expulsion: Parents are supplied with course rules upon enrolment. In the event that a student seriously breaches those rules, Brooke House reserves the right to summarily dismiss that student from the course without refund. It is the responsibility of the parents to arrange (either directly or via their representative) for the student to leave the college the same day. Leicester Road, Market Harborough, Leicestershire, LE16 7AU, England Telephone: +44 (0)1858 462452, Facsimile: +44 (0)1858 462487 Email: summerschool@brookehouse.com www.brookehousecollege.co.uk