Sea English Academy Enrollment Form
Course Location |
| -- Please choose an option --Australia: Sunshine CoastAustralia: CabooltureAustralia: Sydney CityAustralia: Gold CoastThailand: Chiang RaiUSA: MontanaJordan: AmmanChina: Shenyang |
Agent Option |
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If you are registering through an authorized Sea English Academy Agent, please state the Agent Name: |
| Agent Name: |
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Personal Information |
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Last Name* |
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First Name* |
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Middle |
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Street |
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Suburb |
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State |
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Post Code |
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Country |
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Phone Number |
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Your email address* |
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Date of Birth
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Male
Female |
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Nationality |
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Passport Number |
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Visa & Health Insurance |
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Do you require a Student Visa? |
Yes |
No |
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Do you need to SEA to apply for Overseas Health Cover? |
Yes |
No |
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If yes, for how long? |
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Level of English |
Beginner
Intermediate |
Elementary
Advanced |
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Completed Exam |
Yes |
No |
Date Completed
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Exam Score:
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Course Details |
Certificate in English
Certificate IV TESOL
Diploma of TESOL
English for Academic Purposes |
Business English
IELTS Preparation
Study Tour
Other |
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Hours Per Week
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No. of Weeks
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Start Date
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Finish date
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Accommodation |
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Accommodation required |
Yes |
No
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Homestay
Backpackerr
Hotel |
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Accommodation Length of Stay (weeks) |
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Start Date
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Finish Date
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Health |
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Allergies or medical conditions etc |
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Airport Pickup |
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Do you require pickup from the airport? |
Yes |
No
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| I have read the Student Handbook and I confirm that I am fully aware of and agree to all the conditions of Sea English Academy International Policies and Procedures |
| Yes |
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