Last Name Gender M F

First Name Date of birth [dd/mm/yy]

Place of birth Nationality

Address

Tel. Fax

E-mail

Occupation Company 

Work Tel. Work Fax

Work E-mail

- Are you a student? YES  NO

- If so, what school or university do you attend?

- What are your hobbies and/or interests?


- Please choose your language of study Italian English French German Spanish

- How many years experience do you have with the language?

- Please choose your level of comprehension Beginner Elementary Pre-Intermediate Intermediate Upper Intermediate Advanced

- Please enter the code of the Language Course(s) and/or Internship you would like to take
(View course codes: Italian / Other Languages)

- Please enter the name(s) of any cultural course(s) you would like to take


- If you interested in take one of our new group courses please send
an email to: info@sorrentolingue.it

- Reason for studying the language:
College Credit Professional Pleasure Other Other

- I found out about the school through...

- Number of weeks From [dd/mm/yy] To [dd/mm/yy]

Travel Information:
Is this your first visit to Italy? YES NO

Travel Airport Transfer required? (The cost is 75 Euro per person one way)
YES NO

Flight no. arrival:

Flight no. departure:

Date [dd/mm/yy] and time of arrival (airport) (preferably the Sunday prior to the start of the course)

Date [dd/mm/yy] and time of departure (airport)

- The school will be closed on the following National Holidays: February 14th, March 24th ( Easter holiday ), April 25th, May 1st, June 2nd, August 15th, November 1st, December 8th. There will be no lessons on these days. No refund of fees. From December 24th, 2008 to January 7th, 2009 the school will be closed for the Christmas holidays. There will be no lessons on these days.

Have you purchased travel insurance? YES NO

Choose your accommodation of preference
Hotel: One star Two star Three star Four star Five star
Apartment: Studio One bedroom
Shared Apartment: Single room Double room
Family: Single room Double room
No accommodation

If you are living with a family, please indicate your choice of boarding
Bed & Breakfast Half-Board

I would like to share accommodation with:

Emergency contact while in Italy:
First name:

Last name:

Address:

Telephone:

Mobile:

Email:

Relationship to the student:

Special needs preferences:
Allergies (ex: cats, dogs, etc.):

Smoking allowed Non-smoking

Special requests, we do our best to satisfy these, but they are not guaranteed (ex: private bathroom, swimming pool, etc.):

Health issues (ex: asthma, heart problems, diabetes, etc.):

Meals (if bed and breakfast or half board):
Foods I do NOT eat include (ex: red meat, pork, poultry, fish, dairy, etc.):

Have you attended courses with us before? YES  NO

If so, when?

Notes:
 

General conditions for Italian classes:
1) Enrollment To enroll, it is necessary to complete the appropriate form. The form must be completed in all its parts and signed by the participant. The enrollment form must be accompanied by a deposit equal to 30% of the full amount. 2) Confirmation of enrollment Once the application and deposit have been received, the Centre will forward confirmation of registration. 3) Settlement of payment Payment must be settled within three days from student's arrival. 4) Payment Payment can be effected by credit card, by cash or bank transfer to: Credito Italiano - Agenzia di Sorrento 62M C.C. 000004736732 CAB 03401 ABI 03226 5) Discount for married couples or brothers and sisters Should participants be either married or brothers and sisters, a discount of 10% will be made on one account. 6) Insurance Students are advised to take out medical insurance in their own country before departing. 7) Participation Sorrento Lingue never cancels a class. Thus, there is no class min. However, we reduce the number of hours according to class size or number of participants. The Minimum number of students in group classes is three. Classes with less than three participants will be reduced from 4 hours to 2.5 hours. 8) Cancellation of participation Cancellations should be sent by registered mail. If a cancellation is made more than 21 days before the beginning of the course, the school will refund the deposit except the registration fee, which can be applied to a future course within 12 months of the original course starting date. Deposits and fees are not transferable from person to person. If a student does not attend, withdraws or shortens his/her course after the course has begun, tuition and accommodation fees will not be refunded. No refunds of course and accommodation fees are allowed for a delayed start or premature departure. LAST MINUTE ENROLLMENTS (within 1 week before the beginning of the course): if a student does not attend, withdraws or shortens his/her course, the school will not refund the deposit paid and will require the total payment of course and accommodation fees. No refunds of course and accommodation fees are allowed for a delayed start or premature departure. I hereby consent to the aforementioned conditions. We inform you, according to the Italian law D.L. 196/03, art. 13 concerning privacy, that your personal data will be used according to the Italian privacy law, also through mechanical instruments and/or automated ones, only to fulfil legal obligations, to realize the completion of all necessary formalities linked to the conclusion, implementation and management of your contract. Place: Date: Signature: