LearnOverseas

To apply for a work-experience placement, please fill the form below. We will email you a confirmation, which will be followed with more detailed information once we have received your deposit.

You can also download this form and mail it to us later. Please click here to download the printable version of the application form.

Application Form

1. Personal Details
First Name:	*
Surname:	*
Telephone no:	*
Mobile/Cell:
Email address	*
Home Address	*
Post Code

2. Your Education Details (please fill details relevant to your time of travel)
Are you a student?	Yes No
Level
School/University Address
Post Code
Proposed University
Intended Degree subject
If you are not a student then please give us more information on your occupation and any details of proposed study and subjects:

3. General Information (please fill details relevant to your time of travel)
Wish to go with a friend doing similar work-experience in Delhi?	Yes No
If yes, your friends name
Do you have any handicaps or disabilities?
Do you have any special dietary requirements?
Please add any information ‘Learn Overseas’ should know in order to ensure your placement is suitable for you (please include any health issues):
Hobbies and interests:
What do you hope to gain from the placement?
Where did you first hear about ‘ Learn Overseas’?

4. Passport Details We need your passport details for our records. Please fill in the details below and send us a photocopy of the ‘photo’ page of your passport
Nationality
Date of Birth
Place of Birth
Passport Number
Country of Issue
Date of Issue
Date of expiry

5. Next of Kin Details (for contact in the event of an emergency) Details of any change to next of kin must be given to the Manchester Office immediately in writing, signed and dated by you.
Title/td>
First Name
Family Name
Address
Post Code
Relationship to you
Home Tel Number
Mobile/Cellphone No
Work Tel Number
E-mail:

Please tick to accept to abide by the terms & conditions of Learn Oveseas:

Please send us two copies of your passport photo and a cheque of £200 to cover your deposit. Cheques should be made payable to ‘Learn Overseas’ and sent to the address below. If you are under 18 years of age at the time of travel, please print and attach the parent/ guardian consent form with your cheques.

Learn Overseas,
47 Greenheys Centre,
Pencroft Way Manchester Science Park,
Manchester M15 6JJ