Quote / Application Form Course Application Form Personal DetailsName* Vorname Nachname Nationality*Date of Birth* Datumsformat:TT Schrägstrich MM Schrägstrich JJJJ Address* Anschrift Anschrift Zusatz Ort Bundesstaat / Provinz / Region PLZ AfghanistanÅlandinselnAlbanienAlgerienAmerikanisch-SamoaAndorraAngolaAnguillaAntarktisAntigua und BarbudaArgentinienArmenienArubaAustralienÖsterreichAserbaidschanBahamasBahrainBangladeshBarbadosWeißrusslandBelgienBelizeBeninBermudaBhutanBolivienKaribische NiederlandeBosnien und HerzegowinaBotswanaBouvetinselBrasilienBritisches Territorium im Indischen OzeanBrunei DarussalamBulgarienBurkina FasoBurundiKambodschaKamerunKanadaKap VerdeCaymen InselnZentralafrikanische RepublikTschadChileChinaWeihnachtsinselKokosinselnKolumbienKomorenKongo, Demokratische Republik desKongo, Republik desCookinselnCosta RicaCôte d'IvoireKroatienKubaCuraçaoZypernTschechische RepublikDänemarkDjiboutiDominicaDominikanische RepublikEcuadorÄgyptenEl SalvadorÄquatorial GuineaEritreaEstlandKönigreich Eswatini (Swasiland)ÄthopienFalklandinselnFäröer-InselnFidschiFinnlandFrankreichFranzösisch-GuayanaFranzösisch-PolynesienFranzösische Süd- und AntarktisgebieteGabunGambiaGeorgiaDeutschlandGhanaGibraltarGriechenlandGrönlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard und McDonaldinselnHeiliger StuhlHondurasHongkongUngarnIslandIndienIndonesienIranIrakIrlandIsle of ManIsraelItalienJamaikaJapanJerseyJordanienKasachstanKeniaKiribatiKuwaitKirgistanDemokratische Volksrepublik LaosLettlandLibanonLesothoLiberiaLibyenLiechtensteinLitauenLuxemburgMacaoMazedonienMadagaskarMalawiMalaysiaMaledivenMaliMaltaMarshall-InselnMartiniqueMauretanienMauritiusMayotteMexikoMikronesienMoldawienMonacoMongoleiMontenegroMontserratMarokkoMosambikMyanmarNamibiaNauruNepalNiederlandeNeukaledonienNeuseelandNicaraguaNigerNigeriaNiueNorfolkinselNordkorea (Volksrepublik)Nördliche MarianenNorwegenOmanPakistanPalauPalästina, BundesstaatPanamaPapua Neu GuineaParaguayPeruPhilippinenPitcairninselnPolenPortugalPuerto RicoKatarRéunionRumänienRusslandRuandaSaint-BarthélemySt. HelenaSt. Kitts und NevisSt. LuciaSt. MartinSaint-Pierre und MiquelonSt. Vincent und die GrenadinenSamoaSan MarinoSão Tomé und PríncipeSaudi-ArabienSenegalSerbienSeychellenSierra LeoneSingapurSint MaartenSlowakeiSlovenienSalomonenSomaliaSüdafrikaSüdgeorgienSüdkoreaSüdsudanSpanienSri LankaSudanSurinamSpitzbergenSchwedenSchweizSyrienTaiwanTadschikistanTanzaniaThailandOsttimorTogoTokelauTongaTrinidad und TobagoTunesienTürkeiTurkmenistanTurks- und CaicosinselnTuvaluUgandaUkraineVereinigte Arabische EmirateGroßbritannienU.S.A.UruguayUS Minor Outlying IslandsUsbekistanVanuatuVenezuelaVietnamBritische JungferninselnAmerikanische JungferninselnFutuna (Wallis und Futuna)WestsaharaJemenSambiaSimbabwe Land Sex*MaleFemaleAge*Bitte gib eine Zahl von 0 bis 100 ein.Profession*Email* E-Mail eingeben E-Mail bestätigen Mobile Number*PassportNumber*Expiry Date*Place of Issue*Student Card PhotoPhotos must be taken within the last six (6) months. The photos must be taken against a plain white or light-coloured background. Head must be directly facing the camera with full face in view. The photos must be clear, sharp and in focus. Either black and white or colour photos are acceptable.Student Card Photo UploadAkzeptierte Datentypen: jpg, png, jpeg.Letter of AcceptanceThe letter could be used for academic, professional or visa application purposes and will be issued against a fee of €50 and upon full payment.Do you require a letter of acceptance?*NoYesKindly inform us with the reason for the letter*AcademicProfessionalVisa applicationHow Did You Find Out About Us?*AgentColfuturoFondo Nacional del AhorroConnectingUinMaltaVisitMaltaSchools and AgentsMy Guide MaltaGoogleFacebookTwitterInstagramUniversity Language School WebsiteEdufindOtherPlease SpecifyAgency / Agents NameNewsletterWould You Like to receive promotional material and subscribe to our Newsletter?*YesNoBooking DetailsKindly provide us with your tentative or actual arrival and departure dates. Flight details could be communicated later.Arrival Date* Datumsformat:TT Schrägstrich MM Schrägstrich JJJJ Arrival - Flight NumberIf you don't know your flight details for now, you can leave this out.Time : HH MM AM PM FromDeparture Date* Datumsformat:TT Schrägstrich MM Schrägstrich JJJJ Departure - Flight NumberIf you don't know your flight details for now, you can leave this out.Departure Time : HH MM AM PM If you don't know your flight details for now, you can leave this out.ToTuitionI would like to apply for the following course*General English CourseFEBRUARY 2020 SPECIAL OFFER - General EnglishEASTER 2020 Special Offer - General EnglishIntensive English CourseConversation ClassEarly Bird Offer 2020 - Intensive English CourseCombined General + BusinessCombined General + One to OneIELTS Intensive - January SessionIELTS Intensive - April SessionIELTS Intensive - June SessionIELTS Intensive - September SessionIELTS Evening - January SessionIELTS Evening - May SessionIELTS One to One CourseSummer Teens ProgrammeOne to One TuitionWeeksTotal number of One to One tuition hoursTotal number of specialised One to One hoursAccommodationChoose type of Accommodation*No Accommodation* SUMMER TEEN PROGRAMME ACCOMMMODATIONResidenceHost FamilyHotel KapparaNights*Bitte gib eine Zahl größer oder gleich 0 ein.In a*SUMMER TEEN PROGRAMME ACCOMMODATIONTownhouse apartment (8 bedrooms + 5 bathrooms)Postgraduate apartment (3 bedrooms + 3 bathrooms)Standard apartment (1 bedroom + 1 bathroom)In a*NO ACCOMMODATION NEEDEDSUMMER TEEN PROGRAMME ACCOMMODATIONSingle RoomSharing RoomOnNo BoardBed and BreakfastHalf BoardFull BoardChoose your board basis which is offered at the cafeteria (optional)Hotel Kappara Room*StandardBalconyHotel Kappara additional services Guest Breakfast Self-Catering Room In a*Single RoomSharing RoomOn*Bed and BreakfastHalf BoardFull BoardChoose your board basis which is offered by the host family (required)Please tick if you have any of the below preferences Family with no pets No smoking family Any food allergies or dietary requirements (Please Specify)Accommodation address in Malta IF NOT BOOKED THROUGH MULSIf you do not wish to book accommodation with Malta University Language School (MULS) kindly provide us with the address of where you will be staying in order to issue an obligatory student card.TransfersChoose if you would like optional airport transferChoose a airport transfer*One way transferTwo way transferNO TRANSFER NEEDEDLeisure PackageChoose a leisure packageWinter Leisure PackageSummer Leisure PackageThe Winter package is available from November to May and the Summer package is available from May to October. For more information kindly visit the following page - https://www.universitylanguageschool.com/leisure/Health ConditionsDo you suffer from any medical, physical or psychological condition that may affect your stay, or the stay of co-students, at Malta University Language School?*YesNoPlease SpecifyBooking CommentsCommentsTerms and ConditionsPlease carefully read the Terms and Conditions. * I confirm that I have read and accept the terms & conditions CAPTCHADate Datumsformat:MM Schrägstrich TT Schrägstrich JJJJ PhoneDieses Feld dient zur Validierung und sollte nicht verändert werden.
