Language Centre Application Form

1Introduction

2Personal details

3Course

4Further details

5Confirmation

This form is to book Language Centre English courses.

Why is information needed and how will it be used?
- To communicate payment instructions, provide joining instructions, and let you know about any important changes to course information
- To help us improve our course offerings and internal record keeping
- To monitor equal opportunities
Privacy Notice overview
- GDPR legal basis
- Data sharing and retention
- Profiling
- Health information
Read the full Privacy Notice

All fields marked * on the form are required.
Privacy Notice * REQUIRED
- I have read and agree with the Privacy Notice

Personal details
Name * REQUIRED
As it appears on your passport.
Given Name Family Name
Preferred name
If different from the above.
Nationality * REQUIRED
Gender * REQUIRED
- Female
- Male
- Non binary
- Prefer not to say
Date of birth - must be dd/mm/yyyy format * REQUIRED
DD slash MM slash YYYY
Personal email * REQUIRED
Mobile phone number * REQUIRED
Home address * REQUIRED
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Application details

If you are booking through an agency, please tell us who they are.
Agency name
Agent's email address
If you are not booking through an agency, please tick here:
- No agency
Your English level

If you are not sure, please see the Your Language Level page on our website for a description.
What is your current level of English? * REQUIRED
If you have a recent IELTS certificate please upload it
Max. file size: 3 MB.

Course application

Select the course you would like to study from the list.
Course 1 * REQUIRED
Start date * REQUIRED
Start date * REQUIRED
Start date * REQUIRED
Would you like to book another course? * REQUIRED
- Yes
- No
Course 2 * REQUIRED
Start date * REQUIRED
Start date * REQUIRED
Start date * REQUIRED

Health information

The health information in this section with be processed under GDPR Article 9 (2) a - Explicit Consent. Please leave blank if you don’t consent to us processing this information or don’t want to provide it here. You can email language-centre@arts.ac.uk directly to give us this information later, or if you want to change or delete it.
Do you have any long-term medical conditions or disabilities?
- Yes
- No
Please give details.
Emergency contact

Please provide details for a contact we that we can get in touch with in case of emergency. A contact could be a parent, guardian, relative or spouse.
Name of emergency contact * REQUIRED
Given Name Family Name
Relationship to you * REQUIRED
Does your emergency contact speak English? * REQUIRED
- Yes
- No
Emergency contact email address * REQUIRED
Emergency contact phone number * REQUIRED
Finish your application
How did you hear about us? * REQUIRED
Tell us where you first heard about the Language Centre.
Terms and conditions

All bookings are subject to our terms and conditions 2020.

Please read these before submitting this booking form.
I have read and accept the Language Centre's terms and conditions * REQUIRED
- Confirm
Marketing

Please tick ‘I agree’ if you give your permission for us to contact you about other courses or services offered by the Language Centre which you may be interested in.

For this purpose your contact details will be processed by Campaign Monitor outside the EEA. You can view their Privacy Notice here: campaignmonitor.com/policies/#privacy-policy.
I would like to receive updates. * REQUIRED
- I agree
- I do not agree
You can ask UAL Language Centre to stop using your details by clicking the unsubscribe link at the bottom of emails you receive or by emailing lcmarketing@arts.ac.uk.

{all_fields}
Name
This field is for validation purposes and should be left unchanged.
Phone
This field is for validation purposes and should be left unchanged.

Why is information needed and how will it be used?

Privacy Notice overview

Personal details

Application details

Your English level

Course application

Health information

Emergency contact

Finish your application

Terms and conditions

Marketing