Course Package Booking Form

To book your Oxford English Experience Course Package, please complete the form below. You will need to complete the form again for each person attending.

Please telephone if you have any enquiries regarding your booking.

We will contact you within 3 working days to confirm your booking.

Please complete all fields

Personal Details

Family Name:
Other Names:
Age:
Sex:	Male Female
Nationality:
Language:
Email Address:
Home Address:
Post/Zip Code:
Home Phone:
Mobile Phone:
Fax:

Emergency Contact Details

Name:
Sex:	Male Female
Nationality:
Language:
Home Address:
Post/Zip Code:
Home Phone:
Mobile Phone:

Package Required

Please select the package you require:
Date you wish to start (must be a Monday):
Package Length:	1 Week 2 Weeks

Needs Analysis

Your Job:

Are you studying for a recognised international English examination? If so, please give details here:

Include this examination in your package? Yes No

Do you have any medical conditions which we should be aware of? Yes No

If so, please give details here:

Please select your level of spoken English:
(1=poor, 10=excellent)

Please select your level of written English:
(1=poor, 10=excellent)

Please use this space to tell us what you want us to include in your English tuition:

Terms and Conditions

I confirm that I have read and accept The Oxford English Experience’s Terms and Conditions. I understand that the balance of fees is due four weeks before my start date.