Free Trial English Lesson

Would you like a trial lesson online or in school in Manchester? (required)
---onlinein school in Manchester

When would you like to take your free trial lesson? Subject to availability

Your Details:

Your Name (required)

Your Email (required)

Your Telephone Number (required)

Date of Birth (required)

Are you under 18?(required)
yesno

Gender (required)
---MaleFemale

Your Nationality (required)

Information for school

First language (required)

Why are you learning English? e.g.for an exam or study, for work, for travel, to meet new people. Give as much detail as you can. (required)

Do you have any conditions for which you might need extra learning support? eg dyslexia, communication difficulties (required)
---yesno
If yes please provide us with more information

Permissions

If you booked your course via a school or agent please give their name here

Please state here if you are happy for IH Manchester to share details about you and your course with the school or agent named above
yesno

I confirm that all the information I have provided on this form is true and correct.
YesNo