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PERSONAL DETAILS |
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Name* |
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Surname* |
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| Nº Passport/ NIE* |
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Address* |
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| City* |
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Postal Code* |
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Country* |
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| Tel.* |
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| Fax |
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Mobile |
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E-mail* |
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| Date
of birth* |
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| Sex |
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Nationality |
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Profession |
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Company |
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Contact in case of
emergency (name and number) |
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KNOWLEDGE OF SPANISH |
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Level |
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How long have you
studied Spanish? (hours)
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Mother tongue |
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Other languages |
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Why do you want to
improve/learn Spanish? |
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REGISTRATION FOR
COURSE |
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Course
Level
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Nº of weeks
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Select start date
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Select end date
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Accommodation |
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Accommodation type
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Nº of weeks
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Select start date
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Select end date
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Are
you smoker?
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Are you allergic to something?
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Type allergy
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Transfers |
Transfer type
Transfer on arrival from
to
,
nº of flight
and time of arrival
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Transfer on departure from Dénia to airport
of
,
nº of flight
and time of departure
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COURSE COSTING* |
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Course |
€ |
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Accommodation |
€ |
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Transfer |
€ |
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Totall |
€ |
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METHODS OF PAYMENT
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Amount to pay* |
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Way of payment* |
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BANK TRANSFER to:
TLC Denia
Bank Office: CAM. Patricio Ferrandiz, 16. ES03700 Dénia SPAIN
IBAN: ES81 2090 0226 15 0040058792
Swift code: CAAMES2A
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Credit card data |
| Type
of card |
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Cardholder name |
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Number |
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Expiry date |
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| HOW DID YOU HEAR OF THE LANGUAGE CENTRE? |
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FRIENDS |
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NEWSPAPER |
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MAGAZINES |
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LEAFLETS |
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RADIO |
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INTERNET
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OTHERS
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COMMENTARY
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