Course Registration

Please complete the following form in order to register for an LSC course. Please note that once the form is submitted, we will send you an email confirmation outlining next steps and the total amount of fees owing. Please ensure that you submit a valid email address.

Personal Information

First Name: *

Family Name: *

Date of Birth: *

Gender: *

Male

Female

Nationality: *

Native Language: *

Contact Information

Address 1:

Address 2:

City:

Country: *

Email: *

Please enter a valid email address.

Fax:

Telephone: *

Emergency Contact Information

Emergency Contact Name: *

Emergency Contact Country:

Emergency Contact Telephone: *

Emergency Contact Fax:

Course Information

Choose your LSC centre:

City / Cities Offered:

Course Description:

Courses:

Language Level:

N/A

Beginner

Intermediate

Advanced

Start Date:

End Date:

Number of Weeks:

Arrival Information

Airport Pickup Required:

N/A

Yes

Arrival Date:

Arrival Time:

Arrival Flight Number:

How did you hear about LSC?

Referral Source:

Referral Details:

If you selected any of the above, please tell us the publication or magazine name, the website address or any other type of way that you heard about LSC.

Languages

Course Registration