Study Spanish in Spain: Bienvenido: formulario

Enrolment Form

Please, fill the following form in BLOCK letters and clic the "send" button. You will receive a confirmation with our bank account and other details (read section "How to get there?") by e-mail or postal mail in the next days. Please note that postal mail can take 2 or 3 weeks.

Dates:

First name

Phone (mobile)

Second name

Town/Zip Code

Age

Country

Sex

Phone

Address

Fax

Type of course:

Course level:

E-mail:

Location:

Course number:

Arrival time:

Accommodation:

Arrival by:

Starting date

/ /

How do you want to receive your confirmation?

Number of weeks

Other Details:

Do you wish receive information about a medical insurance?

Are you vegetarian?

In case of emergency please, contact:

Name

Town

Country

Telephone

Address

Zip Code

Message: please write here your questions and/or any specific requests you may have
("Intensitive-Plus" courses, private classes, better equipped flats...)

Message

I will pay the deposit of 90€ (= 90 EURO) immediatly on receipt of the confirmation of reservation either by international postal order or eurocheque to your address or by bank transfer to your account.

The balance due is to be paid at the beginning of the course in Spain.