Application Form

English Study Breaks Application Form

STEP 1
Title*
Name*
First Last
Date of Birth*
Please enter your date of birth
Gender*
Contact Telephone Number
Please include your Country Dialling Code and do not insert gaps between numbers
Email Address*
Enter Email Confirm Email
STEP 2
Where would you like to study?
Please enter where you would like to study (e.g. London, Edinburgh, York)
Date of study break commencement?
Enter preferred date of when you would like to start your study break?
Date of study break completion?
Enter preferred date of when you would like to end your study break?
An arrangement fee of £85.00 is required to accompany your application (which is non-refundable), receipt of this will secure your place on the course. This should be paid within 5 days of sending your application form.

All payments to ESB must be made to Study Breaks (UK) Limited through the PayPal secure payment system.

An e-mail will be forwarded to you when confirmation is received by us from the Academic Institution. Then the full amount English Study Breaks of the course fee and accommodation will be payable by you, within 14 days. Payment details as above.

*This will be at extra cost
Any booking is made subject to ESB’s standard terms and conditions and I agree that I have read and accept them.*
- Yes, I accept
- No, I do not accept