Booking Form for University Hall of Residence 2010

To book a place at International Summer School's University Hall of Residence please complete the following form. We will contact you with regards to payment which can be done by credit card via fax. Please do NOT enter your credit-card details below or e-mail them to us!

Booking Form

Before completing the form please read the Terms and Conditions.

Student Details
Family Name:
First Name:
	Boy Girl
Nationality:
Date of Birth:	Day 12345678910111213141516171819202122232425262728293031 Month 123456789101112 Year 19851986198719881989199019911992199319941995199619971998
First Language:
Knowledge of English - Only Intermediate and Advanced courses offered:	Intermediate Advanced
Is the student in good health:	Yes No
If "No", please provide details:
Do you require insurance? (£48 for length of stay. See Terms and Conditions for details.):	Yes No
Parental Details
Name of parent or guardian:
E-Mail Address:
Postal Address:
Home Telephone:
Work Telephone:
Fax:
Emergency Contact Details
Name of emergency contact:
Address:
Home Telephone:
Work Telephone:
Fax:
How did you hear about International Summer School [ISS]:
Airport Transfer: Meet and Greet Service We are happy to meet children at Heathrow, Gatwick, Stansted and London City airports, and Eurostar Train stations at Ashford, Ebbsfleet and St Pancras. Children are met by I.S.S. staff who transfer them to the school. On departure ISS Staff will accompany children to the Airport/Train Station and assist with check-in and stay with them until they go through to passports. Discounts are available if students are travelling together.
Do you require airport transfer?	Yes No
If "Yes" please choose airport/train station:	Heathrow (£200 return) Gatwick (£155 return) Ashford (£200 return) Stansted (£220 return) St Pancras (£240 return) Ebbsfleet (£210 return) London City (£230 return)
Additional waiting service where International Summer School staff remain in the airport or train terminal building until the flight or train departs - this particularly applies to Unaccompanied Minors (UMs):	Waiting service (£30)
Weeks Required Please select your preferred dates.
Total number of weeks (Price per week £705):
Summer:	4th July - 10th July 11th July - 17th July 18th July - 24th July 25th July - 31st July 1st August - 7th August
Parental Consent For Students Aged 16 and 17 Years I hereby allow my son/daughter to participate in unsupervised outings during their stay at International Summer School.
Name of Parent/Guardian:
Optional Activities You can only do one activity per week.
Sailing/Canoeing 6 hours per week £115	Number of weeks:
Windsurfing 6 hours per week £115	Number of weeks:
Cycling/Mountain Biking 2 hours per week £38	Number of weeks:
Tennis 6 hours per week £110	Number of weeks:
Swimming Lessons (beginners only) 3 hours per week £55	Number of weeks:
Golf 6 hours per week £140	Number of weeks:
Horse riding 1 hour per week £50	Number of weeks:
Horse riding 2 hours per week £100	Number of weeks:
Horse riding 3 hours per week £150	Number of weeks:
By submitting the form you state that you have read and agree with the Terms and Conditions. Records will be maintained and divulged to third parties only within the provisions of the Data Protection Act