Bath Academy | Junior Course Individual Application Form

Junior Course Individual Application Form

Personal Information Child's Family Name: First Name: Known As: Gender: Male Female Date of Birth: Country of Origin: First Language: Home Address: email Address: Telephone Number: Emergency Contact Name: Emergency Contact Number:

Course Information Preferred Dates of Study:

From:
To:

Length of Stay:

About Your Child He/She Likes: He/She Dislikes:

Which of The Following Best Describe His/Her Personality ?

Extrovert	Introvert
Optimistic	Pessimistic
Independent	Needing Support
Solitary	Sociable
Mature	Less Mature

Photograph Please select a passport style photo of your child. The photo should be in JPEG format and not larger than 250K

Medical and Welfare

	Yes	No	Details
Has your child ever suffered from a serious medical condition ?
Is your child undergoing a course of medical treatment ?
Will your child bring any medicine or drugs with them ?
Has your child had a serious illness within the last 12 months ?
Does your child suffer from asthma ?
Does your child have any allergies (including food)
Does your child have any mental or physical difficulties ?
Is there any food your child cannot eat ?
Do you allow your child to smoke (students over 16 only) ?
If you have any other special requests or any medical/personal information that you need to include, please give details:

Accommodation

Please indicate the type of accommodation you require for your child:.

No accommodation
Homestay accommodation
Executive family accommodation *
Full board hostel accommodation *

* Subject to availability

Dates Required:

From
To

If you require family accommodation, please answer the following questions to help us place your child with a suitable family: Interests, hobbies and sports: Any special accommodation requests ?:

Does your child like pets ?:

Yes No

Travel Arrangements Do you wish us to arrange airport transfers ?: Yes No

If 'Yes' please give details below:

Arrival Date	Departure Date

Arrival Time	Departure Time

Arrival Airport	Departure Airport

Arrival Flight No.	Departure Flight No.

Arrival Terminal	Departure Terminal

From	To

Unaccompanied Minors (Please refer to our Terms & Conditions)

I will register my child with the airline as an unaccompanied minor to be collected from the airport by a Bath Academy driver.

Please note:

If you book with a 'ticketless' airline you must send the booking reference number with your child.

It is essential that all the flight information is correct, as we are unable to accept responsibility for checking flight information with the airport concerned

Payment
To secure a place on a Bath Academy course you must

Pay a £250 commitment fee per student at your earliest convenience (to guarantee accommodation etc) and a non-refundable Registration Fee of £50 and arrange for full payment of your fees to be made at least 10 days before your course is due to start

Or make a full payment with your booking

All fees must be paid in pounds sterling. You may pay your deposit and your full fees by bank transfer, international bank draft or (for applications from within the UK only) cheque.

Fees are payable to:

Barclays Bank PLC
Knightsbridge Corporate Centre
London

Account Name:
Bath Academy

Account Number:
50881767

Sort Code:
20-06-05

SWIFT BIC:
BARCGB22

IBAN:
GB93 BARC 2006 0550 8817 67

Feedback How did you hear about Bath Academy ?:

Apply

By entering the code below, I certify that the above information is true and correct and that I have read and accepted the Terms and Conditions. Please tick here if you are NOT happy for your child's picture to be used for Bath Academy's promotional purposes
	Verification Code	Date: