English Course Registration

Username

Password

Full Name

Contact Number

Contact email

Full Address

What do you think is your current English level?

What do you hope to acheive from the course?

Course of Interest?

English - Elementary levels English - Intermediate A2 / B1 level English - Intermediate B1 / B2 level English - Advanced B2 upper level English - Advanced C1 level English - General Conversational English English - Professional / Work

Prefared course type

Group classroom Private lessons classroom Private lessons online

Your Nationality

Payee's Name if not student

Payee's email for the purpose of invoices

I give my full consent to the use of material(s) which may contain images of me or a person(s) for whom I'm responsible in the promotion of Leir, it's academy and business through social media (Facebook, twitter etc.) including their website(s)

Yes I give my concent No I do not give my concent

No payment is required now, but please select your payment method from below and an invoice or estimate will be issued prior to the start of your course. Please note payment is required in full before the start of any course, program or class.

Payment Method

Banking On-Line Cash payment Credit Card

By acknowledging and signing below, i am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.

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In line with Data Protection Laws & Recent GDPR regulations in order to submit this form you need to offer specific consent

Yes I give concent