BROOKLYN SCHOOL OF LANGUAGES, LLC

ENROLLMENT FORM

SCHOOL GENERAL INFORMATION

Brooklyn School of Languages
Address:	16 Court Street, 34th Floor Brooklyn, New York 11241
E-mail:	info@brooklynschooloflanguages.com
Phone:	+1 347 763 6905
Fax:	+1 718 395 1591
Website:	www.brooklynschooloflanguages.com
Facebook:	www.facebook.com/pages/brooklyn-school-of-languages.com
Key Personnel:
Richard Ambler School Director rich@brooklynschooloflanguages.com	Stephanie Bon Sales and Marketing Manager stephanie@brooklynschooloflanguages.com

STUDENT DETAILS

First Name:	Date of Birth: (mm/dd/yyyy)
Last Name:	Nationality:
Gender:	Male Female	Native Language:
Home Address:
Home Phone:	Cell Phone:
E-mail:

Do you have any special learning needs? Yes (please explain below) No

(e.g. dyslexia, dysgraphia, non-verbal learning disabilities…)

EMERGENCY CONTACT

First Name:	Relationship:
Last Name:	Phone:
E-mail:

PROGRAM DETAILS

Type of Course:
Level in English:
Start Date: (mm/dd/yyyy)
End Date: (mm/dd/yyyy)
Number of Weeks:

ARRIVAL DETAILS

Airline:	Date of Arrival: (mm/dd/yyyy)
Flight Number:	Time of Arrival:
Airport of Arrival:
Airport Transfer needed upon arrival?	No	Yes: JFK Airport - $150 Newark Airport - $175

DEPARTURE DETAILS

Airline:	Date of Departure: (mm/dd/yyyy)
Flight Number:	Time of Departure:
Airport of Departure:
Airport Transfer needed upon departure?	No	Yes: JFK Airport- $150 Newark Airport- $175

HOUSING OPTION (IF APPLICABLE)

Type of Accommodation:	Type of Room:
Housing Start Date: (mm/dd/yyyy)	Housing End Date: (mm/dd/yyyy)
*Standard housing dates start on the Sunday before your course starts and end on the Saturday after your course ends. Any additional days will be charged as extra nights
Personal Preferences:
Family with pets:	No Yes	Smoking:	Smoking Non-Smoking
Private Bathroom: $50/week supplement	No Yes	Family with children:	No Yes
Food Allergies:
Personal Interests:
Additional Information:

ADDRESS WHILE IN NEW YORK (IF APPLICABLE)

Address while in New York:
*If housing is not booked through the school

HOW DID YOU HEAR ABOUT US?

Internet	Friend - Who?	Agency – Which one?
Other - Please explain:

YOUR LANGUAGE LEARNING GOALS

Check all that apply:	Personal	Academic	Professional	Other -
What do you hope to achieve from this program?

PAYMENT DETAILS

Payment Method
Payment can be made via our Payment Portal below, in order to reduce extra fees for all parties: https://merchant.pay-ed.com/Payment/BSL1 Alternatively, payments can be made using the following methods: Bank Wire Transfer
Brooklyn School of Languages, Account No. 660-902-281, with HSBC Bank USA, 452 Fifth Avenue, New York, NY 10018, USA, SWIFT Code MRMDUS33, Routing # 021001088 *All banking fees (inbound and outbound) must be paid by the student
Credit Card:
Name on Card:	Type of Card:
Card Number:
Expiration Date:	Security Code:
Billing Address:
I hereby authorize Brooklyn School of Languages to charge my credit card in the amount of: $
Signature of Cardholder:	Date:

HEALTH INSURANCE

Brooklyn School of Languages does not require its students to obtain health insurance. However, it is highly recommended that all students have and maintain health insurance during their time in New York City. It is important for students to be aware of the risks and possible consequences for the failure to maintain health insurance. Please speak with a BSL staff member for more information about health insurance.

Recommended Health Insurance Provider:

BSL highly recommends booking health insurance via guard.me international insurance.

*Use code 4025 to get a discounted $2/day rate.

YOUR AGREEMENT

The above listed school and student enter into agreement under which the student will pay tuition and fees as indicated on the school’s websitehttp://brooklynschooloflanguages.com/prices.htmlas well as adhere to the school’s rules and regulations as set forth in the BSL student handbook. By my signature, I agree to the conditions of this agreement. I also verify that I have read and received a copy of the agreement.

Signature of Student orStudent Sponsor (if under 21 years of age)	Date

TERMS AND CONDITIONS

All registrations are subject to the following conditions, which become legally binding once the registration is confirmed by Brooklyn School of Languages.

1. Registration and Booking
All bookings submitted to Brooklyn School of Languages (BSL) are only accepted on receipt of written confirmation from BSL or its authorized representative. A $300 deposit per student is payable at the time of booking (individual or group bookings) for course only bookings, and $600 for course + accommodation bookings. Payment in full must be received a minimum of 28 days before the course start date, or immediately in the event of late booking (bookings made within 28 days of the start date). All payments must be in US dollars.

2. Cancellations and Refunds
All cancellations must be made in writing and will be confirmed in writing by BSL.

Cancellations are subject to the following charges:

● More than 28 days before course start date: A full refund will be made.

● Between 14 and 28 days before course start date: $300 administration fee.

● Less than 14 days before course start date: $300 administration fee and $300 accommodation fee (if applicable).

● After course start date, no refund will be applicable for courses of 4 weeks or less.

● For courses longer than 4 weeks, students who terminate their course after 4 weeks but before or at the mid-point of the course, a pro-rated amount of tuition will be refunded.

● No refunds apply for courses cancelled after the mid-point.

Please note: refunds are calculated from the end of the last week the student attended classes at the non-discounted rate. Pro-rated refunds will be calculated on a weekly basis.

3. Visa Support
As our courses are all within the 18-hour per week limit set by the relevant US government departments, both our Adult courses and our Junior summer camp courses can be followed on a tourist visa, or ESTA if applicable. Where relevant, we will supply supporting documentation to enable students to secure tourist visas for the US. The Intensive Course Option (30 lessons, 22.5 clock hours per week) is only available for U.S. residents and citizens.

4. Alterations by the Student
Any alterations by the student must be confirmed in writing and BSL will respond in writing. BSL recommend students arrange full insurance cover against possible cancellation charges.

5. Reduction in Lessons
In the event that there are insufficient students to form a class, BSL reserves the right to offer the student individual classes as an alternative. The lessons maybe reduced as follows:

● Standard courses (morning and afternoon) (20 lessons): reduced to 10 individual lessons (of 45 minutes in duration)

● Semi-Intensive and Business courses (22 lessons): reduced to 11 individual lessons (of 45 minutes in duration)

● Part-Time Evening course (20 lessons, 20 clock hours): For 2 students only, reduced to 4 weeks, eight-hour classes (16 clock hours). Evening courses are not available for 1 student only.

● Intensive course (30 lessons): reduced to 24 individual lessons (of 45 minutes in duration)

6. Maximum Lessons for Business Course

For the Business English Course, students are permitted to take a maximum of 8 weeks (184 lessons) of this course. For students wanting to study for longer, they will need to switch to a different course after their eighth week.

7. Lessons Lost on Bank Holidays
When the holiday falls on a Monday, classes will begin on Tuesday. Lessons falling on school holidays will be made up during the rest of that week.

Thanksgiving: classes lost that week will be partly made up during the week. Students will have 4 days’ worth of lessons over 3 days (therefore only one day will be lost).

8. Level of English
8.1 If a student does not have the minimum level of English required to follow a specific course, as determined by the BSL placement test, BSL reserves the right to move the student to an appropriate course for their level.

8.2 For the Business English Course, students must score a minimum of Upper Intermediate on all 3 sections of the placement test (grammar/vocabulary/reading comprehension, speaking, and writing) to be eligible to take the Business English Course. If students do not receive the score of Upper Intermediate on all of the sections, yet score Upper Intermediate when all sections are averaged together, they will be placed in the Upper Intermediate level in the Semi-Intensive English Course until they are ready to be moved in the Business English Course.

8.3 The Summer Junior Program has a minimum level requirement of pre-intermediate – students at beginner or elementary level cannot be guaranteed a class.

9. Airport transfers.
Students must submit their flight details (airline name, arrival time, flight number and point of origin) and their contact cell phone number to the school at least 7 days before their departure/arrival. The student's cell phone is used only for airport transfers in case the driver cannot find the student and has to get in touch with him/her. BSL does not use students’ cell phone number for any other purpose.

The school cannot be held liable for any extra charges if the student has not provided his/her contact cell phone number for airport transfers (if the student cannot find the driver and has to make his/her own way to his/her accommodation for example).

10. Disciplinary and Behavior Issues
BSL reserves the right to refuse or exclude any person at any time prior to or during the operational dates of the center if in the opinion of BSL, that person is incompatible with the general well-being and safe running of the center. This includes, but isn't limited to criminal, abusive or violent behavior, putting themselves or others at risk, use of alcohol by minors, use of illegal drugs, and refusal to follow the rules of the center. In this instance, no refund will be given and any costs incurred, including damages, will be passed on to the student or their parents/guardians, including any repatriation costs.

11. General

11.1 Arrangements and courses outlines in BSL publicity materials are given in good faith. However, courses, activities and timetables may be subject to change for reasons of safety, or in the event of unsuitable weather conditions or other factors, which may arise beyond our control. BSL reserve the right to change the particularities of courses, including changes to course, venues, facilities or dates of programs where circumstances beyond our control necessitate such changes or where the level of bookings received does not reach the minimum number required to operate a course viably. In this event, BSL shall either provide comparable services or refund such part of that service which relates to the change. In either case, BSL’s liabilities shall cease and clients shall have no other or further claim against BSL.

11.2 BSL reserves the right, by giving notice to clients at any time before the start date, to increase the price of the service being provided to reflect any increase in costs to BSL, which is due to factors beyond BSL’s control, such as, without limitations, significant increase in accommodation costs, transport costs, labor costs etc. BSL does not accept liability for personal injury or the death of any student unless caused by the proven negligence of BSL or its servants.

11.3 Provision by BSL of the services outlined in this document and other promotional material, is dependent on receipt of a completed liability disclaimer form, health information sheet and the student's acceptance of the various rules imposed by BSL.

11.4 Any complaints against any aspect of the services provided by BSL should be addressed in the first instance to the local representative on site. In the event that the matter is not resolved, the client or his agent should make an immediate complaint in writing to BSL’s main office. All complaints will be investigated by the school and may be subject to an appropriate refund provided that the complaint is deemed to be valid, the complaint received within one month of the end of the course and that all fees and costs associated with the booking had been settled in full as laid out in the details above.

12. Approval to Use Image, Video & and Printed Material
BSL may take photographs and/or videos during the stay for promotional purposes. By agreeing to appear in any photographs/videos, the student agrees that BSL may use these images to promote their products and surrenders any right to royalties. To request that a specific image be removed from the public domain because it is felt inappropriate, students must contact BSL in writing.

13. Liability and Force Majeure
BSL does not accept any liability for the loss of damage of any property belonging to students. BSL accepts no responsibility for losses or additional expenses in the event of cancellation (whether whole or part) or change due to acts, omissions, or accidents beyond the reasonable control of BSL, including, without limitations, delays in travel services, obligatory compliance with any government order, rule, direction or regulation, an Act of God, riots and/or civil commotion, war or hostilities, acts of terrorism, invasion, explosion, accident, fire, flood, lightning, storm, illness, widespread disease or infection.