Easy Languages

Please indicate any supplemental information about your programme (as necessary)

Lessons per week

Options

Departure

Return

Duration (weeks)

In general, programmes run from Sunday to Saturday unless otherwise indicated in the programme description page.

Accommodation typePlease SelectHost FamilyResidenceShared ApartmentOtherNone

Room typePlease SelectIndividualShared

BoardPlease SelectFull BoardHalf BoardBreakfast OnlyNo Meals

Non-smoker familyno preferenceyesno

Family without childrenno preferenceyesno

Family without petsno preferenceyesno

Special Diet

Allergies or medical issues

Interests and hobbies

Preferences

Name of a friend that you wish have as a roommate

The types of accommodation and board available for each programme are detailed on the programme description page and are subject to availability. Please note that supplements may apply to certain accommodation options.

Family Name

Given Name

GenderMaleFemale

Date of birth

Age

Place of birth

NationalityAustriaBelgiumBulgariaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGermanyGreeceHungaryIrelandItalyLatviaLithuaniaLuxembourgMaltaMonacoNetherlandsPolandPortugalRomaniaSlovakiaSloveniaSpainSwedenUnited KingdomAlbaniaAndorraArmeniaBelarusBosnia and HerzegovinaCroatiaGeorgiaGibraltarGreenlandIcelandMacedoniaMoldovaMontenegroNorwayRussiaSerbiaSwitzerlandTurkeyUkraineBelizeCanadaCosta RicaEl SalvadorGuatemalaHondurasJamaicaMexicoNicaraguaPanamaPuerto RicoUnited StatesArgentinaBoliviaBrazilChileColombiaCubaDominican RepublicEcuadorGuyanaHaitiParaguayPeruUruguayVenezuelaAfghanistanAustraliaBangladeshBruneiCambodiaChinaFrench PolynesiaSri LankaGuamHong KongIndiaIndonesiaJapanKazakhstanKyrgyzstanLaosMalaysiaMongoliaNepalNew CaledoniaNew ZealandPakistanPapua New GuineaPhilippinesSingaporeSouth KoreaTaiwanTajikistanThailandTurkmenistanUzbekistanVanuatuVietnamBahrainIranIraqIsraelKuwaitJordanLebanonOmanQatarSaudi ArabiaYemenSyriaTurkeyUnited Arab EmiratesAlgeriaEgyptLibyaSudanTunisiaMoroccoBeninBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadDRC (Congo)DjiboutiEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauIvory CoastKenyaLesothoLiberiaMalawiMauritaniaNamibiaNigerNigeriaRepublic of the CongoRwandaSenegalTanzaniaTogoUgandaAngolaBotswanaComorosMadagascarMauritiusMozambiqueSwazilandZambiaZimbabweMaliSouth Africa

Mother Tongue

Level in the target languageA0 Complete BeginnerA1 (Beginner)A2 (Elementary)B1 (Lower Intermediate)B2 (Upper Intermediate)C1 (Advanced)C2 (Mastered)

Do you suffer from...NoneAttention disorderDifficulties with learningOther issues the teacher needs to know (please be precise)

Please Describe

Telephone

Cell/Mobile

Name of emergency contact

Relationship to student

E-mail

Telephone (mobile preferred)

I wish for Easy Languages to arrange my travelYesNo

I wish for a transfer from the airport or train station to my accommodationon arrival onlyon arrival and departurenone

Attention! If you wish to arrange your travel yourself, we highly recommend that you wait until receiving our confirmation of your booking before making reservations.

I would like the cancellation guaranteeYesNo

I would like to purchase medical insurance (required for non-European destinations, strongly recommended for European destinations)YesNo

Promotion Code

General Remarks

CurrencyAustralian DollarsBrazilian ReaisCanadian DollarsSwiss FrancsEuroBritish PoundsJapanese YenKorean WonNew Zealand DollarsPolish ZlotychUS Dollars

Send invoices to:Please SelectParticipantParent / GuardianOther

Name of person or company

Telephone

Payment MethodPlease SelectCredit Card (+2% processing fee; suggested if departure in less than 4 weeks)Bank TransferPersonal CheckOther (voucher, credit note ...)

Name on card

Card TypePlease SelectMasterCardVisa

Card number

Expiry (mm/yyyy)

I authorize the charge of this card in accordance with the conditions below.

If your departure is to take place within 4 weeks, the sum should be paid immediately. Otherwise, a deposit of 250€ is asked for programmes of fewer than 4 weeks and 1000€ for longer programmes.

I accept the General Conditions