Enrolment form

Personal details

First name *

Family bame *

Date of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Nationality

Home Address (Street)

City

Post code

Country

Phone

Mobile

Fax

Email *

Course choice

Course name * Arcades Individual D.E.L.E.

Course starting date

Nr of weeks

Have you ever studied Spanish? No Yes

My knowledge of Spanish (self-evaluation)

Accommodation

I would like to let the school care about accommodation No Yes

Accommodation type Apartment with other students With spanish family University residence hall Hotel in Valencia

Room type Single Double

Meals Breakfast only Half board Complete

Special requests and comments

Payment

The payment will be made in two instalments:

• first 50% at the enrolment time;
• the settlement of 50% at the arrival to Valencia.

Please, send a fax of the payment to: +34-963509038.

I have already paid the amount of EURO

Payment method Internationa post transfer I-bank

Arcades Del Cid data for the I-Bank:

Bank: Bancaja Valencia
IBAN: ES36 2077 0001 2331 0354 5927 - BIC/SWIFT: CVALESVVXXX

(*) Required fields

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