Individual Student's Enrolment Form for Courses
1. Student's first name:
2. Student's last name/surname:
3. Mailing Address:
4. Phone Number:
5. Email Address:
6. Age Group:
7. Birth date:
8. Gender: MaleFemale
9. Supervisor Name (if applicable):
10. Supervisor phone number (if applicable):
11. Supervisor email address (if applicable):
12. Supervisor relationship to student (if applicable): ParentTeacherOther
13. From which environment will you be learning English?
From home as an independent student
From a school - What is the name of your school?
From a business - What is the name of your business?
14. When do you want to begin your class?:
15. Select your class:
Beginner    Business English 1
Elementary   Business English 2
Pre-Intermediate   Teacher Training
Intermediate    (contact the office for more information)
Upper Intermediate   Private Tutoring
FCE Preparation    (contact the office for more information)
CAE Preparation
CPE Preparation
IELTS Preparation
Please use the following table to determine the total program cost for the class(es) which you have chosen for this trimester.
Courses Chosen   Cost Per Course Sub-Total
0 X $275 $0
Registration Fee $55
Billing Information
Enter your credit card information:
Name on card:
Card Type:
Card Number:
Expiration Date:   
Card Security Code:   What is this?
As a security measure, your credit card will NOT be charged automatically when you submit this registration. A member of the Red Rock ELC staff will manually charge your credit card for the cost when he/she receives your registration.
Thank you for completing this application. Click on the "Submit" button below to send your application information to the director of the Red Rock English Language Centre.