B2B - Application Form

This form is for Agents only, if you are an individual, please fill in this form instead:

Booking Information Request

Personal Details of Student

(exactly as shown on passport)

First Name

Last Name

Date of Birth

Country of Birth

Nationality

Passport number

Phone/Mobile

Sex

Male

Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

English level

(you can find information on levels HERE)

Location and Programme

Student Type

Adult

Young Learner

Course Type

Course Name

Course Type

Course Name

Accommodation

• Please refer to the relevant Price List to check the options available.
• Please note special room requirements at the bottom of the form

Arrival date

Departure date

Type of accommodation

Name of accommodation

Room preferences

If you are booking a shared room, and you know with whom you would like to share, please state their name here:

Food

Room only

Breakfast

Lunch

Evening meal

Are there any animals you cannot live with?

Other

Do you require smoking accommodation if it is available?

Yes

Transfers

Do you require transfers?

Yes

Transfer Required

Arrival transfer

Departure transfer

Arrival Transfer Information

Flight Number

Departure Airport

Flight Departure Date

Flight Departure Time

Arrival Airport

Flight Arrival Date

Flight Arrival Time

Departures Transfer Information

Flight Number

Departure Airport

Flight Departure Date

Flight Departure Time

Arrival Airport

Flight Arrival Date

Flight Arrival Time

Special Requirements and Health

Some description about this section

Do you have any allergies, medical conditions, special dietary requirements, disabilities or special educational needs?

Yes

If yes, please type in below

By signing this application form you are agreeing that: you have read, understand and agree to the Terms and Conditions for Students and the privacy policy at www.lalschools.com/terms and the current Price of LAL Language Centres; the laws of the place where the LAL Language Centre where you will study is located will apply to any agreement arising out of this application form, and you will abide by and study within the terms of any visa which may be required for your course.
LAL will only use your image for its own promotional materials and will secure your data. Please see our Privacy Policy for more information on how LAL manages personal data.

If you agree to LAL using your image for photography, filming or sound recording, please tick below.

Agency Name

First Name

Last Name

Agency Email

Booking Currency

USD ($)

EUR (€)