Family name

    Given name

    Date of birth

    Student's mobile

    Address

    City

    Zip Code

    State/Province

    Country

    Student's age

    Passport Number

    Expire date

    Note: In order to reserve a place, it is essential to present a photocopy of your passport/ID card, the deposit to reserve a place (details at the bottom of the form) and the completed programme conditions sheet.

    Father's name

    Phone number

    Mother's name

    Phone number

    Tutor's email

    Another contact in case of emergency, if parents cannot be reached:

    CONTRACTED PROGRAMME

    HEALTH: Indicate if the student has any problems that require special attention (allergies, diets, medication, etc.). This information will be requested later and in more detail if appropriate.

    We will ask you to fill in the ‘Profile Bulletin’ to get to know the student better.

    How did you hear about our programme?

    REGISTRATION FEE: 500€, already included in the course fee.
    To make the reservation effective, please use the online payment method of Laois Language Centre, at laoislanguagecentre.ie «Reserve a Place»

    G E N E R A L C O N D I T I O N S

    1. REGISTRATION FEE: The registration fee must be paid at the time of registration. If the registration request is not accepted, the registration fee will be returned.

    2. The order of entry of the registration will be respected for the acceptance of the registration.

    3. PAYMENTS: Payments must be made online. Apart from the registration fee, two other payments of the remaining 50% will be made. One will be made before 31 March 2025 and the second before 31 May 2025.

    4. CANCELLATION or abandonment of the programme: any cancellation for reasons not covered by the included insurance (including Covid19) will result in the loss of expenses incurred up to the date of cancellation. Consult deadlines.

    5. PHOTOGRAPHIC PERMISSION: Permission is granted to Laois Language Centre to use in the future all photographic material in which the student appears, for the promotion or advertising of its programmes. Please notify us in writing if you do not grant permission.

    6. PASSPORT: it is essential to travel with a valid passport and, if necessary, COVID documentation.

    7. EMERGENCIES: Laois Language Centre is expressly authorised to take the decisions it deems appropriate in the event of an emergency, illness or accident.