SECURE SERVER THIS IS A AJAX (JAVASCRIPT) FORM TECNOLOGIA AND IT'S CERTIFIED AS SECURE SERVER FOR PERSONALE DETAILS TRANSMISSION DATA

NOTE: this is the alternative enrollment form without the using of Javascript. If your browser does support Javascript, you can fill in our enrollment form or you can download our enrollment form in pdf format and send it by fax at the number +39 055 290396.

PERSONAL DETAILS

Date of Birth

Address

 PART 2: ITALIAN LANGUAGE COURSE


Please fill in one application form for each city of choice in case you want to enroll for different locations.

N.B.: You can book several courses. Please use the following 3 fields.






Starting dates:


 PART 2b: COURSE 2






Starting dates:


 PART 2c: COURSE 3







Starting dates:


 PART 2d: ADDITIONAL COURSE

PART 3: MY KNOWLEDGE OF ITALIAN LANGUAGE


If 'Yes' please complete the following:






PART 4: ACCOMMODATION


If 'Yes' please complete the following:


N.B.:
Lodging costs for family and apartment
accommodation have to be paid upon the arrival in Italy.

For all accomodations: We need your credit
card number as guarantee to make reservations



PART 5: TRANSFER

If yes, please give details:

PART 5: PAYMENT

Together with the application, the school must receive the payment of the registration fee (=70 Euro). The balance of the course fees is due not later than 21 days prior the beginning of the course.

For late enrollments (less than 21 days prior the beginning of the course) the total tuition fee must be paid upon enrollment.

In case of bank transfer, please make sure that any bank fee is charged to the sender ("OUR" instruction).

I choose the following method of payment

If you chose online credit card please specify:



Euro









If you chose credit card for fax:



by means of the following Credit Card:

For security reasons, please fill in the appropriate form with your credit card details (* and, in the case of Amexco, also the additional number), and fax it to the following number of our registration centre: +39 - 055.290.396


PART 6: TO SEND ENROLLMENT My registration implies the acceptance of the General Conditions of Participation as mentioned in the Scuola Leonardo da Vinci web site and brochure.

OTHER INFORMATION (not obligatory)

HOW DID YOU HEAR ABOUT SCUOLA LEONARDO DA VINCI





Consent in accordance with Art. 23 of D. Lgs. 196/2003. The person concerned, having received the information furnished by the data processing owner in accordance with Article 13 of D.Lgs. 196/2003, hereby consents to the processing of his/her personal data for the purposes indicated in the aforesaid informative note. He/she also consents to the communication of his/her personal data for the purposes and to the subjects indicated in the informative note.

I herewith confirm my enrollment at Scuola Leonardo da Vinci I don't accept to send my details

To send the enrollment is obligatory to accept