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ITALIAN LANGUAGE COURSES ENROLMENT FORM 

Please fill in the form below to enrol in our Italian language courses. It is important to fill in as many fields as possible.
NB – Enrolment shall become effective as soon as payment for at least one month of course has been made. Advance payments can be made online, by bank transfer or by international money order.
Should you wish to attend lessons for less than one month, please pay at least one week’s fee in advance.

    ☆ Personal Details

    First name*

    Surname*

    Gender*

    Place of birth*

    Date of birth* (dd/mm/yyyy)*

    Nationality*

    Passport Number

    Full address*

    e-mail*

    Telephone*

    Fax

    ☆ I wish to attend an Italian language course…

    I wish to attend the course commencing on*:

    2025

    2026

    I wish to enrol for:*
    (seleziona la tua scelta ☑︎ ) 1 MONTH (€ 700,00/month) 1 WEEK (€ 200,00/week) SPECIAL OFFER - 4 months (€ 2.600,00) SPECIAL OFFER - 6 months (€ 3.600,00) SPECIAL OFFER 1 year - 12 months (€ 6.000,00)

    Please state the number of consecutive months or weeks in which you wish to attend: (e.g. 2 months, 3 weeks, ...)

    ☆I require accomodation*:

    (select ☑︎ )

    YES NO

    If yes, please choose the type of accommodation:

    ☆ I would like to pay…*

    (seleziona la tua scelta ☑︎ ) … with Credit Card … by bank transfer … by international money/postal ___ Notice on consent: In compliance with the provisions of Legislative Decree 196/2003, we would like to inform You that the provided data shall be processed, exclusively for the purposes for which they have been collected, and to keep you informed on our new or other services. Data shall be stored confidentially and shall not be transferred to third parties. ___
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    PAY NOW

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    Dati bancari:

    INTESTATARIO: Istituto Linguistico Bertrand Russell

    BANCA: Intesa San Paolo; Agenzia 50383 VIALE EUROPA, 26 – 35018 SAN MARTINO DI LUPARI (PD)

    IBAN: IT55 H030 6962 8271 0000 0007 857

    BIC o SWIFT: BCITITMM

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    Istituto Linguistico Bertrand Russell | P.IVA 05457370285 | Corso Garibaldi 18, Padova 35122 IT | +39049654051 mobile +393472354860

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