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Phone

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English level*

Please complete our contact form for more information about what we can offer beginner level students.

Name*

Title First Name Family Name

Date of Birth*

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Email*

Mobile phone*

Nationality*

First language*

Please select the course you require*

Please note that courses start on Mondays and end on Fridays.

Start date*

End date*

Do you need support with specific needs?*

Yes

Please click all that apply*

Dyslexia

Dyspraxia

Dyscalculia

ADD

ADHD

Autistic spectrum

Visual difficulties

Hearing difficulties

Mobility issues (e.g. difficulty climbing stairs)

Other (Please tell us about this below)

What support do you need with these?

Please specify

Do you have any medical conditions or allergies?*

Yes

Please specify and tell us if you need any support with these.

Do you require Homestay accommodation?*

Yes

Homestay Accommodation

Please provide required Homestay accommodation dates if known.

From*

To*

Emergency Contacts

Name	Email	Phone	Relationship	Date of birth	What is this person's first language?	Actions

There are no Emergency Contacts.

Maximum number of emergency contacts reached.

Please add at least one emergency contact.

Will you be under the age of 18 years at the start of your course?*

Yes

Parent / Guardian

This section to be completed by the student's parent or guardian.

Parent / Guardian name*

Title First Last

Parents and students, please confirm you fully understand all the following information.*

English in York offers language tuition for independent individuals and groups

The majority of students studying with us are adults (aged 18+).

Students aged 16 and 17 are accepted onto our courses, subject to parental consent. These students will be taught with adult students unless booked as part of a closed group.

Students under 18 studying on our courses will not be supervised during breaks, or after school has finished and will come into contact with adult students.

English in York fees include tuition only. Students are expected to pay for their own transfers, refreshments, lunch, social programme activities, bus pass and ancillary costs. Homestay is charged at a separate cost.

The school offers 24 hour emergency assistance. Please call +44 1904 636771 (school hours, Monday to Friday 8:30 to 17:00) or +44 7808 918876 (EMERGENCY ONLY- evenings & weekends)

Are you and your child happy for their image to be used in photos and videos to be used for promotional activities?*

Yes

Emergency contact consent*

I understand

I confirm that the emergency contacts may act on my behalf if I am not available. I understand that I need to be contactable by telephone (24 hours per day) in case of emergencies. If I am not contactable, the emergency contacts will be available to take an emergency call.

How will your place on this course be funded?

Self funded

Government sponsorship

Are you happy to be included in English in York's photos, videos and other promotional material?*

Yes

Please upload a copy of your passport photo page*

Drop files here or

Max. file size: 16 MB.

Behaviour Pledge

I agree:

not to look at any websites or pictures showing violence, unkindness or sex when I'm in school or share these with other students

not to send photos, videos or messages that could make another student sad or unhappy

not to take or send photos, videos or messages of other students unless they say it is okay

only to use kind and good words in my messages to other students.

E-safety Agreement (student)*

I understand this E-safety Agreement and the importance of acting safely and legally online. I accept that this Agreement is part of English in York’s rules.

E-safety Agreement (parent)*

I understand this E-safety Agreement and have helped my child understand his /her responsibilities and the importance of acting safely and legally online. I accept that this Agreement is part of English in York’s rules for under 18s.

Terms & Conditions*

I agree to English in York’s policies, terms and conditions, and privacy notice.

How did you hear about us?

Other

Fluent English for Professionals

Business Communication

English & Culture for 50+

Book Your Course

Do you have these ready?

Homestay Accommodation

Parent / Guardian

General English

General English & IELTS

Fluent English for Professionals

General English 1:1 Intensive

Business Communication

English & Culture for 50+

Closed Groups

Book Your Course

Do you have these ready?

Homestay Accommodation

Parent / Guardian