REGISTRATION FORM
SPECIALIZATION MODULES

I wish to enroll in Oxford Seminars Speciailization Modules:
  Teaching TOEFL Preparation Teaching English to Children
  Teaching English Grammar Teaching Business English
 
Mr.   Miss   Mrs.  Ms. 
 
    (          )  
First Name (Please Print) Last Name (Please Print) Telephone Number Email Address (Please Print)
 
Please mail module to:
 
         
Address (Please Print) Apt. City State Zip Code
 
Charge my credit card: Visa   MasterCard   American Express   Discover
 
     
Card Number Expiry Date Signature
 
Credit Card Billing Address:
 
         
Address (Please Print) Apt. City State Zip Code
 
I have enclosed: $400 Full Course Fee
 
Please make check/money order payable to Oxford Seminars
 
Students Signature:   Date:  
 
This registration form shall become legally binding when signed by the student and accepted by Oxford Seminars.
 
FAX THIS COMPLETED REGISTRATION FORM TO 1-800-955-9950, OR
MAIL YOUR REGISTRATION FEE ALONG WITH THIS COMPLETED REGISTRATION FORM TO EITHER:
OXFORD SEMINARS, 12335 SANTA MONICA BLVD., SUITE 337, LOS ANGELES, CA 90025
OXFORD SEMINARS, 244 5TH AVENUE, SUITE J262, NEW YORK, NY 10001-7406