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Full Name *

Surname *

Gender *

Date of Birth *

Nationality *

Passport Number *

City

Country *

Email Address *

Room newsletters, Passport

Phone Number

WhatsApp Numbers

Course Type

Course Level (If Known)

Preferred Start Date

Course Duration

Type Of Accommodation

Room Preference *

• Special Requirements (e.g., dietary, allergies, mobility)

Arrival Date for Accommodation

Will you require a student visa?

• Do you have health insurance? Yes / No (Aurora can provide guidance)

Declarations & Agreements (Agree/Disagree) *

• I confirm that the information provided is correct. • I agree to Aurora Language Centre’s terms and conditions, policies, and code of conduct. • I consent to Aurora storing my data for academic, safety, and administrative purposes. • I understand the cancellation and refund policy.

Optional Marketing / Communication Consent (I would like to receive emails, newsletters, and offers from Aurora Language Centre.) Yes / No

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