Personal Details
Name
E-Mail:
Date of Birth
Day	Month   January February March April May June July August September October November December	Year
Nationality		Gender:	Male  Female
Occupation		Address

Years of English to Date
Your level of English is:		Beginner   Elementary   Intermediate   Upper Intermediate   Advanced
The course you wish to follow is:		Group   Individual
Starting Date		Finishing Date
No. of weeks attending school
Accommodation		I wish to reserve:   Family Accommodation   Guesthouse   Self-Catering   Hotel
Arrival Date in Castlebar		Departure Date
Please enter any relevant information concerning your accommodation needs, e.g. allergies, special needs, eating habits, etc.
Your main objectives are:
Communicate with clients   Oral   Written   Write letters   Faxes   Memos   Read professional literature   Communicate with foreign colleagues   Make presentations   For holidays   To read newspapers, magazines   Additional Information     Thank you for taking the time to complete this form.