TESOL Application Form

Suite C - 07 - 01, Plaza Mont' Kiara, No.2, Jalan Kiara, 50480 Kuala Lumpur, Malaysia.
Tel: 603 - 6201 8331 Fax: 603 - 6201 6727

TESOL CERTIFICATE PROGRAMME

APPLICATION FOR ADMISSION

Please complete each item on the application in BLOCK CAPITAL LETTERS and submit it to:

ELS Language Centres c/o Just English Training Sdn. Bhd,
A-12-1 & A-12-2
Wisma HB
Megan Avenue 2
12, Jalan Yap Kwan Seng
50450 Kuala Lumpur.

NOTE: Application form must be received at least 10 working days prior to the start of Face-to-Face classroom sessions

1. Name ( As you want it to appear on your certificate)

Name

Surname

2. Mailing Address

Street

City/Town

State

Postcode

Telephone Number
E-mails

3. Sex
Male Female

4. Date of birth

Day Month Year

5. Country of Birth

6. Nationality

7. Education (Highest Qualifications Obtained)
Institution (University/College)
Major :
Degree : Dates :
Institution (University/College)
Major :
Degree : Dates :
Institution (University/College)
Major :
Degree : Dates :

Language(s) studied and level of proficiency:

Formal Training/Experience as a Teacher (and subject):

Current Occupation:

Any other information that you feel is relevant to this application, including experience as a private tutor, special seminars/courses undertaken in the field of education, other relevant experience:

7. How did you hear of the TESOL Certificate Programme?

8. In case of emergency, please contact:
Name
Relationship
Contact No.

DECLARATION

Please read the following conditions carefully. Sign and date the final statement. Thank you.

1. ELS Language Centres Malaysia reserves the right to reject an application without explanation.
2. Acceptance of this application does not constitute the reservation of a place in our TESOL programme. A place is only considered once the remaining tuition balance has been paid.
3. All participants should be in a sufficiently good state of health to be able to perform effectively during the programme as full attendance in the Face-to-Face sessions is compulsory.
4. The Certificate in TESOL programme fee is RM4050.00. Participants must pay the fees using the following schedule:

Registration fee of RM300.00 prior to sitting the Language Proficiency test. This is a non-refundable fee.
he next payment of RM2200.00 is due prior to the commencement of the Online lessons.
The 3rd payment of RM1550.00 is due prior to the commencement of the Face-to-Face sessions.

Fees can be paid online (www.els.edu.my) or by cheque/money order payable to ELSI Sdn Bhd or banked into the account stated below

Bank name: Public Bank Berhad
Bank Address: No1&3 Jalan Solaris 1
Solaris Mont Kiara
50480 Kuala Lumpur
Account No: 3150 1781 20
Account Name: ELSI SDN BHD
Swift code: PBBEMYKL

I understand and accept the conditions stated above.

Signature: ________________________ Date: _______________________________