|
All fields are mandatory, so please fill in this Inscription Form in all its parts.
|
|
Personal data
|
|
First name:
|
|
|
Surname:
|
|
|
Gender:
|
Male Female |
|
Date of birth:
|
|
|
E-Mail:
|
|
|
Confirm your E-Mail:
|
|
Passport: |
|
|
Address:
|
|
|
Postal Code:
|
|
|
City:
|
|
|
Country:
|
|
|
Telephone:
|
|
|
Course data
|
|
City:
|
|
|
Course type:
|
|
|
Accommodation type:
|
|
|
Number of weeks:
|
|
|
Starting date:
|
|
|
Comments:
|
|
|
Airport pick-up
|
|
Spanish level
|
|
My Spanish level is:
|
|
|
Please give us more information about where you studied and for how long:
|
|
|
Payment
|
|
The total amount has to be paid (by bank transfer or credit card) not over 4 weeks before the Course starts. Exceptions can be agreed with our company.
|
|
Important:
I have read and accept the QualityCourses' General Conditions.
|
| Please rewrite this image-code below: |
|
 |
|
I'd like to be notified by e-mail about QualityCourses offers.
|
|
How did you find us?
|
|
|
|
Should you have a promotional code, please insert it here:
|
|
Promotional Code:
|
|
|
Code owner:
|
|
|