Sorrento Lingue International Language Centre
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Osia


Last Name Gender

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

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

- Please choose your level of comprehension

- 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:

- Reason for studying the language:
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)

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:



 
      

 

 








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