Piccola Università Italiana
Largo Antonio Pandullo 6
89861 Tropea, Italia

 

Telephone: + 39 0963 60 32 84
Mobile Phone: + 39 349 58 44 114
Fax: + 39 0963 61 786
Skype: piccola.universita.italiana
E-Mail: info@piccolauniversitaitaliana.com
Internet: http://www.piccolauniversitaitaliana.com/
piccolauniversitaitaliana.com
 

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Enrolment: Piccola Università Italiana - Tropea

Piccola Università Italiana – Tropea - The  Italian language school by the sea

 

The enrolment form is to be filled out and sent once by each person. Thank you!

The following enrolment form can be printed and sent to us via internet,  just click on the "send" button below.

 


Personal details
Organisation / Company
Title Mr.   Mrs.
First name, Last name
Street, House nr.
Postal code, City/town
Country
E-Mail
Telephone number
Telefax
Date of birth (dd.mm.yyyy)
Profession / Subject of study
Course details
Course description
Date Monday, the   until Friday, the (dd.mm.yyyy)
Course description #2
Date #2 Monday, the   until Friday, the (dd.mm.yyyy)
Course description #3
Date #3 Monday, the   until Friday, the (dd.mm.yyyy)
Accommodation details
Accommodation
Arrival / Departure Sunday, the   until Saturday, the (dd.mm.yyyy)
Additional days of accommodation before from   afterwards until (dd.mm.yyyy)
Arrival
on
 local time
 Place
 how
 Flight-/Train-Nr.
 Transfer
Departure
on
 local time
 Place
 how
 Flight-/Train-Nr.
 Transfer
Details about visitors during your stay
Language efficiency skills
My Italian language skills
Have you ever taken an Italian course before? no   yes
Why would you like to improve your Italian language skills?
How I found out about the school?
Please:

send me your newsletter
Comments and questions
Anti Spam Verification
Please enter the characters.
Participation conditions

Conditions of Participation 

download or open as .pdf-file

 

 
I have read and understood the conditions of participation and I agree to it.
 

OR

if you prefer to print this form and fax it to us (+39 0963 61786)

City, Date Signature
________________________________________ ________________________________________