:: Bray Language Centre ::

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Bray is an ideal location for a language centre. It’s relatively small size means that students do not have to travel long distances to school.

Part 1 of 7 - Personal Details
First Name*
Last Name *
Gender	Male Female
Address Line 1*
Address Line 2
Address Line 3
Tel
Email
First Language
Date of Birth
English Level
Details of previous courses at Bray Language Centre

Part 2 of 7 - Family Details
Parents / Guardians Names
Add1
Add2
Add3
Tel
Summer Tel No
Summer Address

Part 3 of 7 - Course Details
Course Chosen (Date)*
Course Description	College Course	Four to One Course

Details of special dietary and / or other requirement


Part 4 of 7 - Arrival and Departure Details
Date	Time	Flight No
Arrival

Dep

Do you require an airport transfer ?
Arrival		Departure
Yes No		Yes No

Part 5 of 7 - Parents / Guardians Consent
Minors [ those under 18 years of age ] are not permitted to go out in the evenings unless accompanied by a group leader or a responsible member of the host family. The authorisation to go out in the evening unaccompanied must be signed by a parent / guardian in the space provided below. In any event, the student must give his / her word to re-enter the host family home no later than 10:00 p.m. Bray Language Centre do not accept any responsibility in respect of the student’s failure to re-enter the family home at the prescribed time.

Guardian / Parent * Please tick to indicate consent

Part 6 of 7 - Rules for Parent / Guardian and Student

I the undersigned declare to have read, understood and accepted all the Student Rules of Bray Language Centre. Copy of Rules - click here
Guardian *		Student *

Part 7 of 7 - Payment Details (bank details will be e-mailed to you)
Full Fee or Deposit *
Full Fee , or Deposit of € 300

I will be paying by:
Bank Transfer \| Eurocheque \| Cash
Bank Details will be e-mailed to you.

Please enter all fields marked with *

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Regsitration