This course booking form is for students aged from 10 to 17, if you are an older student or require Hometsy English tuition, please take look at our dedicated Homestay tuition Booking form here. Online Booking Step 1 of 2 50% Please complete our provisional booking form so that we can provide you with the best English Langauge learning Experience with us. By completing this booking form I consent to the processing of my personal data for the specific purpose of booking a course with English Language Homestays.I AM ENROLLING FOR: (*)English Summer SchoolFootball academy with EnglishActive English Summer SchoolJunior English Summer SchoolHomestay TuitionHigh School ProgrammeEnglish in Small GroupsShort stay school groupsHigh School Programme LocationEnglandSouth AfricaDuration1 Week2 Week3 Week4 WeekNumber of hours tuition per week:101520253030+Start date (usually Sunday): End date (usually Sunday): Name First Last Gender: (*)MaleFemaleDate of Birth (*): Nationality: (*)Email: (*) *Must be your own email - we will not use this for marketing.Address: (*) Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home Telephone:Student Mobile: (*)Student Occupation:Interests and Hobbies:Native Language (s): (*)How long have you been studying English?: (*)Current level of English: (*)BeginnerElementaryPre-IntermediateIntermediateUpper IntermediateAdvancedWhat do you feel are your weaknesses when learning English?I am currently studying English with: (*)WHICH LANGUAGE SKILLS DO YOU WANT TO WORK ON?: Speaking Listening Reading Writing Grammar Vocabulary What do you want to achieve from the course?:Which location would you prefer: AccommodationPlease say whether you have any special requests about accommodation (eg pets in the home), dietary requirements or allergies:Do you smoke?: (*)YesNoDoes the student have any medical conditions or learning difficulty ?Which Activities/Excursions would you prefer:Extras (please see brochure for fees). I would like to book: A private bathroom One extra night homestay Two extra nights homestay Accompanying adult (no tuition) Accompanying child (no tuition) Additional 1:1 tutorial Christmas supplement New Year supplement Visa documents by express mail Extra excursions If you are booking extra excursions, please note requests here:How did you hear of English Language Homestays?Search EngineBlogFacebookTwitterOther WebsiteFrom RecomendationsOther This iframe contains the logic required to handle Ajax powered Gravity Forms.