333 - Italian for foreigners, Japanese, On-line enrolment

PERSONAL DETAILS
Surname*:	Name *:
Sex:	Date and Place of Birth *:
Age *:	Nationality*:
Mother language*:	Profession:
Address *:	Home phone number :
Office phone number :	Fax:
E-mail *:	Company information: (if the invoice is to be addressed to the company)

COURSE DETAILS
Level of Italian:	Course location:
Type of course:	Number of weeks of course:
Preferred starting date of course*:	I wish to do an exam preparation course CELI / CIC:
Do you want to partecipate in any of these extra activities:
Music	Art
Guided Tours	Italian Cooking

ACCOMMODATION
Family	Hotel
Other	Other (specify):
Date of arrival:	Number of weeks:
room:	board:
smoker:	Food or drink allergies:
Health problems:

ARRIVAL
Date of arrival:	Arrival time:
Flight/train details:	Arriving from:
Arriving at:	Transfer:

STATEMENT

I have read and accepted the "General Conditions ".

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* The undersigned authorises team lingue lecco srl, from this moment onward ,to use the personal data supplied herewith, even transmitting it to other organisations , in order to obtain information requested , on condition that it be used ,exclusively, for the fulfilment of the programme.

The undersigned authorises team lingue lecco srl to use the personal data supplied herewitheven for marketing, promotion and gathering of statistics