Pre-programme Form

Lydbury English Centre Pre-programme form

Please fill in this form as completely as possible - it will allow us to start planning your course programme even before you arrive here.

Please complete all fields marked*

Personal Details

Family Name*		First Name/s*
Email*		Course Start Date*	(ddmmyyyy)
Nationality		Gender
First Language		Other Language/s
Home Address		Date of Birth	(ddmmyyyy)
		Mob/Cell/Tel No
		Fax No

Professional Details
Company Name
Company Address		Tel No
		Fax No
		Job Title

Description Of Your Job
Please describe your job		Who are you responsible to?
Who are you responsible for?		What was your job five years ago?
Your Language Experience
Have you visited the UK or other English speaking countries?	Yes No	If yes, please give details
Please give brief details of any previous English language training.		Please give any further details you think might be useful
If you have been to Lydbury before, please give an approximate date.
English Language Requirements
Your present requirements for English
Do you use English in your present job?	Yes No	If yes, is this mainly -	Written Spoken Both
Is English the working language of your company in your country?	Yes No	Approximately how many hours per week do you use English?
Please enter the positions of a maximum of 8 people you communicate with in English on a regular basis - and how you do this:
Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8
Your future requirements for English
What do you think or hope your job will be in 5 years time?		Will your requirements for English be the same or will it change?
Your requirements for your course programme
Please select the activities where you need training in English - multiple choices possible.
SPEAKING AND UNDERSTANDING	Negotiations Chairing or leading discussions Formal meetings Informal meetings Making speeches Giving presentations Listening to talks Telephone calls Instructing, explaining, demonstrating Social situations Other
READING	Memos Letters Emails Reports Professional & trade literature Instruction manuals Other
WRITING	Memos & letters Emails Reports Other
What do you expect your course to do for you?		What does your company expect your course to do for you?
Are you following a language training course at the moment?	Yes No
If yes, please give details		If yes, what does your language trainer expect this course to achieve for you?
Will you follow a language programme when you return to your company?	Yes No	If yes, please give details
Which of the activities listed above give you particular problems?
Approximately what percentage of your course would you like to be allocated to each of these areas?
Problem 1	%
Problem 2	%
Problem 3	%
Problem 4	%
Problem 5	%
Problem 6	%
Please use this space to give us further information about you or your language training that you might think it might be useful for us to know. Please include information on allergies, medical conditions or dietary requirements.
Please give us the name, telephone number, mobile/cell phone number and email for someone we could contact for you in case of emergency.