English Plus Football Application Form PERSON FILLING IN THE FORMName of person filling formRelationship to studentPlease ChooseParent\GuardianAgentEmail of person filling form If 'Other' please stateINFORMATION ON AGENT (IF APPLICABLE)Name of agencyAgent email address Agent contact nameAgent phone numberINFORMATION ON PARENT OR GUARDIANParent’s full nameParent’s phone numberParent’s email address STUDENT - PERSONAL INFORMATIONStudent's name (as shown in passport) First name Last or family name Student's genderPlease ChooseFemaleMaleStudent's date of birth Student's home addressWhat name do you like to be called at school?For example, my name is Francisco but my friends call me "Paco"Student's mother tongueStudent's passport numberStudent's nationalityStudent's Email address Student’s mobile phone numberSTUDENT – MEDICAL INFORMATIONDo you suffer from any condition which requires special attention?Please selectYesNospecial attention requiredDo you have any special dietary requirements/allergies?Please selectYesNospecial dietaryIs there any other information we should be aware of?Please selectYesNoAdditional InformationSTUDENT – LEVEL OF ENGLISHPlease give us an approximate idea of your level of English by assessing your level of speaking and listening skills on a scale of 0-10 where 0 is total beginner and 10 is a native speaker:Speaking1 Low Level2345678910 Native SpeakerListening1 Low Level2345678910 Native SpeakerENGLISH PLUS FOOTBALL – COURSE DATESStart DateSelect start dateSunday 7th July 2019Sunday 14th July 2019Sunday 21st July 2019Sunday 28th July 2019Finish DateSelect finish dateSunday 14th July 2019Sunday 21st July 2019Sunday 28th July 2019Sunday 4th August 2019ACCOMMODATIONAccommodation will be with homestays. If you want to be in the same homestay as a friend or sibling we need their booking form before we can confirm your accommodationDo you want to be in the same homestay as a friend?NoYesName of person to be withTRAVELAre you travelling alone?YesNoPlease give name(s) of those travelling with youARRIVALWe need the following information to arrange your arrival. If necessary please let us know the airport of arrival - you can confirm the other details later.Arrival Date Do you want to book a Kingsway airport transfer on arrival?Please ChooseYesNoArrival airport in UKArrival airlineArrival flight numberArrival time : HH MM AM PM DEPARTUREDeparture Date Do you want to book a Kingsway airport transfer on departure?Please ChooseYesNoDeparture airport in UKDeparture airlineDeparture flight numberDeparture time : HH MM AM PM Accompanied check-in?Please selectYesNoAccompanied check-in for students is an additional £25.00 cost. Please note this is mandatory for students aged under 16 years.GENERAL INFORMATION + SUBMIT YOUR FORMDo you require a visa letter?Please SelectYesNoAny other information you need to tell us?By clicking the submit button below you agree to our Terms & Conditions. If you have any questions about these please contact us.