☆ Personal Details

First name*

Surname*

Place of birth*

Date of birth* (gg/mm/aaaa)

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*:

2020

2021

I wish to enrol for:*:

(seleziona la tua scelta ☑︎ )
1 MONTH (€ 600,00/month)
1 WEEK (€ 150,00/week)
SPECIAL OFFER - 4 months (€ 2.200,00)
SPECIAL OFFER - 6 months (€ 2.500,00)
SPECIAL OFFER 1 year - 12 months (€ 4.000,00)

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…*

(select ☑︎ )
… with Credit Card (PAYPAL)
… by bank transfer
… by international money/postal

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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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