International English Institue Christchurch, New Zealand

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Courses & Fees

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TOEIC 4 Week Course Form

Check your TOEIC level with our free TOEIC test


Name:
Passport Number:
Date of Birth:
Gender:
Postal Address for Result:
 
 
Telephone:
Email:
Emergency Contact:
English Level:
Questions / Comments

Course
      TOEIC 4 Week Course
  
      TOEIC Test & Score Card
      Enrolment Fees
OPTION
 
Certificate
(If you want a certificate.)
Post Score Card Abroad
(If you want us to send it to your home country)
Post Certificate &
     Score Card Abroad
(If you want us to send it to your home country)
Total Course Costs

Accommodation

   weeks @ per week =

 
Note:Total includes $100 placement fee for homestay and flats and $200 bond for flats.
Start Date:    End Date: 

Homestay

With young children Without children With teenagers I don't mind

I prefer:
My interests are:
Do you smoke?
Do you like pets?

Insurance

All students must have travel and medical insurance.

I will arrange my own insurance.

Please arrange insurance for me.

I want monthly "Southern Cross" insurance for For policy details

I want weekly "Uni Care" insurance for For policy details


Arrival

I require free airport pickup

Flight Number
Arrival Time
Arrival Date

I will send details later
I do not want pickup

How did you hear about IEI?  


Total Costs

I have read and agree to the conditions of enrolment.



International English Institute
PO Box 25 243
71 Bealey Avenue
Christchurch
New Zealand
Telephone:
Fax:
Email:
Skype:		 (64 3) 377 7125
(64 3) 377 7126
office@english.school.nz
international.english.institute

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