Enrolment

Personal information
Surname *
First Name *
Birthday    dd/mm/aaaa
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Nationality *
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Postal Code   
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Fax   
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Spanish Level *
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Course
City *
From    Calendar
Until    Calendar
Number of weeks   
Intensive 15 (Only Alicante and Granada)
Intensive 20 (Only Madrid, Barcelona, Valencia, Sevilla)
Intensive 25 (Only Madrid, Alicante, Granada, Valencia)
Intensive 30 (Only Alicante and Granada)
Long term course
Intensive 25 with: (Only Madrid)
   
Intensive plus (Only Madrid, Barcelona, Seville)
Individual Lessons
Hours per Week   
Topics to be handled    
Standard 6 (Only Madrid)
DELE 20 (Only Madrid)
DELE 30 (Only Alicante y Granada)
Combined Course:
   
Accommodation
Spanish Family:
   
   
   
Shared flat:
   
   
Apartment:
   
Pension:
   
Hotel:
   
   
I´m coming with:
   
Accommodation not required
Miscellaneous
Remarks
   
Airport pickup
Date of flight    dd/mm/aaaa
Arrival Time   
Flight Number   
From   
I want "Contacto" to organize a travel, health and accident insurance for me
Cancellation Insurance. 3% of total cost
Mode of payment
Bank transfer to Academia Contacto. Bank: Caja Madrid. Pza Celenque 2, 28013 Madrid IBAN: ES 79 2038060321 6006416975 SWIFT (BIC): CAHMESMMXXX
Credit Card
   
Card Holder   
Number   
Valid until   
In case you don’t want to send your bank details per internet, you can print this registration form and return it to us by fax: +34 913 66 16 22
Deposit 150 Euros
Total amount
   
I have read the general conditions and accept them.

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General Conditions