Your Spanish School in Barcelona

Application Form


Passport Number: *    
Family Name: * Email: *
First Name: * Age: *
Address: Postal Code:
Country: * Sex: *
Phone: City:
Fax: Home Language:
Emergency
contact phone:		 Emergency
contact name:


SPANISH COURSES *


Dates
From: *  (dd/mm/yyyy)
To: *  (dd/mm/yyyy)


ACCOMMODATION (optional)


· SC: Self-catering, BB: Bed & breakfast, HB: Breakfast & dinner, FB: Full board
· Accommodation is booked from the Sunday before the course starts until the Saturday after the course ends. In case of exception, please specify:

Dates
From:  (dd/mm/yyyy)
To:  (dd/mm/yyyy)


MEETING AND TRANSFER SERVICE
NO YES (extra cost, please specify)
Aeropuerto Barcelona Aeropuerto Girona Aeropuerto Reus
Arrival only   Arrival and departure
Arrival date  (dd/mm/yyyy)
Time of arrival
Flight nº
From


QUESTIONNAIRE
What is your present level of Spanish?................................Level test
   *
How long have you studied Spanish?:
How did you hear about our courses?:


DEPOSIT (150 euros)
VISA/Mastercard * - - -
Cardholder's name: *
Valid until: *  / 


REST OF PAYMENT (at least 1 week before the start of the course)
Charge to my VISA/MASTERCARD
I will send cheque/bank transfer


COMMENTS


 * Compulsory fields.

 I have read and I accept the General Conditions

In accordance with the Law 15/1999, referring to Protection of Personal Data, and the Law 34/2002, referring to Information and Electronic Commerce Services in Society, we hereby inform you that your personal data have been entered in an automatic data file, which is the property of Humboldt Comunicación Intercultural S.A. (ABCHumboldt), for the purposes of sending you school information and special offers, by both regular and e-mail. You can exercise your rights of access, rectification, opposition and cancellation of your given personal data by e-mailing info@abchumboldt.com or by writing to ABCHumboldt, Guillem Tell 27, 08006, Barcelona, Spain.


Credits