LIVE IN

LANGUAGES

LIMITED

 
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Reply to: info@liveinlanguages.com

 Please print this form and scan before attaching to an email. An interactive form will be available here soon. You can also obtain a copy of this form in word format by emailing us.

Live in Languages Ltd – ESL student introduction form

 

Name of introducer/agent:

 

e-mail address:

 

Postal address:

 

 

 

 

 

Contact telephone number:

 

Country of operation:

 

Company name (if applicable):

 

No. of introductions to date:

 

Commission rate:

 

 

 

Name of student:

 

Nationality:

 

Age:

 

Postal address:

 

 

 

 

 

e-mail address:

 

Contact telephone number:

 

 

 

Proposed course:

 

No. of lessons:

 

Course cost:

 

Booking date:

 

Course venue:

 

 

 

Further information/points to note:

 

 

 

 

 

 

 

 

Commission will be paid on receipt of the total course fee from the student.  We will pay you directly to your nominated bank account or via Paypal thereafter.

 

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