Apply Online

Complete and send the form below to apply online.
Alternatively you can download a copy of the application form in PDF format.

Required information is shown in red

General Information

Course Name:

Course Dates From: To:

Surname: First Name:

Sex: Male Female Date Of Birth:

Home Address

Address Line 1:

Address Line 2:

City: State/Province:

Country:

Contact Information

Telephone Number(s):

Fax Number:

E-mail Address:

Nationality:

Contact Person in the event of an emergency

Name:

Relationship:

Telephone Number:

Languages

First Language:

Please list any other languages that you speak and indicate the level:

Language 1: Level: Beginner Intermediate Advanced

Language 2: Level: Beginner Intermediate Advanced

Language 3: Level: Beginner Intermediate Advanced

Language 4: Level: Beginner Intermediate Advanced

How did you learn about Codrington Language Centre

School
Internet
Embassy
Friend/Relative
Other (Please specify):

Travel Please arrange the meeting/transfer service to and from the Sir Grantley Adams International Airport in Barbados:
Yes No

Arrival Date: Flight:

Departure Date: Flight:

Accommodation

Please arrange homestay acccommodation for me: Yes No

List any special dietary requirements:

List any special requests:

Please send me information on villas and hotels in Barbados: Yes No

Deposit Requirements

Details regarding the non-refundable processing fee of US$50.00 sent via wire transfer:

Originating Bank:

Tracking Number:

Date sent:

Confirmation

I have read and understand the information regarding the enrollment procedure, payment requirements, cancellation policies and accommodation

Parent/Guardian's Name:

Enter Text Shown in Picture: