Registration Form
40 Fitzwilliam Street Upper, Dublin 2, Ireland
Telephone: +353 1 6622911
Fax: +353 1 6622929
Email:
Web: www.hornerschool.ie
Type your details directly into the shaded areas & use the drop down menus.

Personal Details:

Surname:

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First name :

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Address:

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Telephone:

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Mobile Telephone:

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Fax:

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Email:

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Date of birth

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dd/mm/yy

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Female:

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Male:

Occupation

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Nationality:

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Native Language:

Other Languages:

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Smoker ?

Use drop down selections à /

No----Yes

Level of English

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Elementary Pre Inter. Intermediate. Upper Inter. Advanced

How did you hear about the Horner School of English ?
Use drop down selections à / See Options belowFriendInternetAdvertisingTravel Agent

Course Details:

â I wish to register for course code: â / Starting:â / Ending: â / Number of Weeks
Course 1 / SELECT COURSE BELOWSTD (Standard Course 20 lessons p.w.)STD+ (Standard Plus Fluency 26 lessons)STD+Business (Standard Plus Business 26 lessons)STD+EXAM (TOEFL Prep 26 lessons)STD+EXAM (IELTS Prep 26 lessons)IEC/20 (Individual Course 20 lessons)IEC/25 (Individual Course 25 lessons)IEC/30 (Individual Course 30 lessons)IEC/40 (Individual Course 40 lessons)SIC/30 (Semi Intensive Course 30 lessons)SIC/25 (Semi Intensive Course 25 lessons)PLATINUM (small grp)PLATINUM +Work Experience ProgrammeEnglish + Sailing / dd/mm/yy / dd/mm/yy
Course 2 / NoneSTD (Standard Course 20 lessons p.w.)STD+ (Standard Course Plus 26 lessons p.w.)STD+Business (Standard Plus Business)STD+EXAM (TOEFL or IELTS Prep)CPC (Cambridge Preperation Course)IEC/20 (Individual Executive Course 20 lessons)IEC/25 (Individual Executive Course 25 lessons)IEC/30 (Individual Executive Course 30 lessons)IEC/40 (Individual Executive Coursae 40 lessons)SIC/25 (Semi Intensive Course 25 lessons)SIC/30 (Semi Intensive Course 30 lessons)PLATINUM (small grp)Work Experience ProgrammePLATINUM +Evening CoursesEnglish + Sailing / dd/mm/yy / dd/mm/yy
Accommodation Details: (Please tick one option from the drop down menu)
No Accommodation RequiredHost Family Single RoomHost Family Twin RoomHorner School CITY Residence (Raymond St.)Shared City Centre Apartment (Shelbourne)Baggot Student Residence (twin share + meals)IFSC Student Residence (Summer Only)Apartment Studio Room (Solar Hse Clontarf)Baggot St. Apt. (studio)Baggot St. Apt. (1 bed)Baggot St. Apt. (2 bed)Trinity College Residence (Summer Only)GuesthouseHotel / You may write any extra information relating to your course & acommodation here

Airport Transfers:

Do you wish to avail of our Airport Transfer Service ? / Yes û / No û
On your arrival
On your departure
Please type your arrival details into the fields below:
Date of Arrival: / dd/mm/yy / Time of Arrival: / xx.xx hrs / Flight Number:
Date of Departure: / dd/mm/yy / Time of Departure: / xx.xx hrs / Flight Number:

Please return this registration form by fax or email, we will then contact you within a short time to confirm your booking details and to advise you of the exact cost of your course. You should then arrange for your full course fees to be paid to our school, using one of the following methods.

Please make your payment by bank telegraphic transfer to:
AIB Bank, 60 Clonskeagh Road, Clonskeagh, Dublin 14, Ireland.
Account Name: The Horner School of English.
Account Number: 12757085.
IBAN Number: IE 80 AIBK 931187 12757085

Swift Code: AIBKIE2D
Bank Code: 93 11 87
If you make a telegraphic transfer from outside the European Union Area, please add Euro 15.00 for bank charges. Students are liable for all bank charges. All bank transfers must be made in the student's name. Telegraphic transfers made from inside the EU area (using the IBAN number above) are usually free of charge.

Visa or Mastercard

Our school can accept payment by Visa or MasterCard Using the PAY ONLINE secure page on our web site.

All monies paid are non-refundable, credits will only be allowed at the discretion of the Managing Director of the School.