16 Mallow Street, Limerick, Ireland | +353 61 415292 | info@english-in-limerick.com
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Please enter your details in the form below and we will respond as soon as possible. Thank you.
First Name(s):
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Family name(s):
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Nationality:
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Passport No:
Gender:
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Male
Female
Date of Birth (mm/dd/yyyy):
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Email:
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Phone (we like to use WhatsApp if possible):
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Course Details:
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GE-20 Standard (Full-time Mornings)
PET-26 Intensive (Full-time Mornings & Afternoons)
FCE-26 Intensive (Full-time Mornings & Afternoons)
IELTS-26 Intensive (Full-time Mornings & Afternoons)
CAE-20 (Full-time mornings)
AY-IELTS Academic Year
AY-PET Academic Year
AY-FCE Academic Year
AY-CAE Academic Year
PET-6 Part-time Afternoons
FCE-6 Part-time Afternoons
IELTS-6 Part-time Afternoons
GE-eves Part-time Evenings
FCE-eves Part-time Evenings
CAE-eves Part-time Evenings
Start date of course (mm/dd/yyyy)
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End date of course (mm/dd/yyyy)
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Do you require an End-of-programme Exam (this is required for non-EU/EEA students who choose Academic Year programmes)?
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Yes
No (I have an EU/EEA passport)
Do you require Medical Insurance (required for non-EU/EEA students)?s
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Yes
No (I am an EU/EEA student)
English Level
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I don't know my level
A1 - Beginner
A1 - Elementary
A2 - Pre-Intermediate
B1 - Intermediate
B2 - Upper Intermediate / FCE
C1 - Advanced / CAE
Online Test Result:
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Accommodation Details:
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I would like Host Family (single room)
I would like City Host (single room)
I would like Host Family (shared room with my friend/partner/sibling)
I would like City Host (shared room with my friend/parent/sibling)
I would like Student Apartment (single room)
I don't need accommodation
Do you have any allergies or medical conditions we should be aware of?
Is there any food you cannot eat?
Arrival Date in accommodation (mm/dd/yyyy):
Departure Date from accommodation (mm/dd/yyyy):
Do you require local arrival transfer?
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Yes, I would like your driver to meet me on arrival in Limerick City centre
Yes, I would like your driver to meet me on arrival in Shannon Airport
No, I can go to my accommodation myself
No, I already live in/near Limerick
Arrival Details/Additional Information:
Why do we need your personal information in this application?
We need the above information to book and arrange your English language programme, accommodation and local arrival transfer. We will not share this information with anyone outside of our organisation unless required by law.
You have the right to access this information at any time - I agree to give Limerick Language Centre the above personal information.
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Yes