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
Participant is adult
Name of parents / guardians
Profession of parents / guardians
E-mail
School
Name of language teacher
School Address
Ages of siblings
Name of emergency contact
Relationship to student
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
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