Enrolment Form

*must be completed

Your infomation
*Name:
*Date of birth: Day: Month: Year:
*M/F:
Female
 Male
*Passport No:
Expity date
Day: Month: Year:
*Nationality:
*Visa type:
Will you apply for student visa through Lalingua?
Yes
*EMAIL：
*Address in home country:
Contact number in home country
Address in Australia:
( if known )
Contact number in Australia ( if known )
*Highest level of education completed:
*What is your English level?:
Beginner
 Elementary
 Intermediate
 Advanced
*Have you taken any of these tests?
IELTS
 Cambridge
 TOEFL
 TOEIC
If yes, When?
What was the result?
 
 
Course infomation
*Course：
Course name
Course time
*Course Starting date We consider your starting date.
You hope start course between...
From : Day Month Year
To : Day Month Year
*Course duration: weeks
*Holiday：
Do you intend to take a holiday, during your course? Yes
If yes,
How long do you want to take a holiday? weeks
Duration From:
To:
Reason
 
 
Other requests
 
TEL:+61-2-9299 8166 EMAIL:info@lalingua.com ADDRESS:Level 3, 93 York St. Sydney 2000 NSW, Australia
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