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Application Form

Select one for which you want to apply :

1. Personal Details
   
 
Mr Ms
  First Name
  Family Name
  Nationality
  Date of Birth :
  Home Address
  Telephone No.
  Mobile No.
  Fax No.
  E-mail
   
     
2. Language
     
  Spanish  
Japanese  
French  
Chinese  
Italian  
Other  
  Other
     
3. Level
     
 
C. Beginner  
Beginner Plus  
Elementary  
Pre- intermediate  
Low-intermediate  
Intermediate  
Upper-intermediate  
Advance  
One to one  
Other  
     
  Number of Weeks studying
     
 
Course Start Date
Course End Date
     
4. Payment
     
 
Course £
TextBook £
Total £
     
  Please indicate payment method?
  Sterling Cheque (Please make cheque payable to UIC Ltd.)
 

Credit Card
- For credit cards please add 3% to your total amount
- For Switch cards please include Issue no. and valid from date

   
Name on Credit Card : * Credit Card Name :*
Credit Card #:*
Card Verification Code:*
Switch Card Issue #:*
Start Date:*
Expiration Date:*
 

Bank Transfer

   

To:

Languages in London
20-71-64
40585815
Barclays
27 Regent Street
SW1Y 4UB


SWIFT CODE - BARCGB22
IBAN GB70 BARC 2071 6440 5858 15
     
  All Course Fees are non-refundable
     
5. How did you hear about UIC?
     
 
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  Other
     
                   Download Terms & Conditions. (PDF)
     
  I have read and I agree with the terms and conditions for 2007 on the attached sheet and the above details are correct.
   
 
 
 
 
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United International College, Language House 76-78 Mortimer Street, London W1W 7SA
Email: enquiry@uiclondon.com
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