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Inscription Form in Austria Language Course

Inscription form

All the fields are with the *asterisk are mandatory. Please fill in your complete information to provide you a quick enrolment.

Personal data


Name:*
Surname:*
Gender:*	male female
Date of Birth:*
E-mail:*
Confirm your E-mail:*
Passport:*
Address:*
Postal Code:*
Country:*
City:*
Telephone:*

Course Data


City:*
Course Type:*
Accommodation:*
Number of weeks:*
Starting Date:*
Comments:

Airport pick-up


*

Your Language Level


My Language Level:*
Comments:

Insurance


We strongly recommend you to contract an insurance – by yourself or taking our Travel, Health and Cancellation Insurance.

Yes, I want to contract your Insurance

Last Step


Payment:*	Payment is always in advance. The total amount has to be payed not over 2 weeks before the Course starts. Payment forms are: - Bank transfer - Credit card
How did you find us?:*

*	I have read and accepted the General Conditions.
	I'd like to be notified by e-mail about your offers.
Security code 4 + 7:*


Should you have a promotional code, please insert it here:
Promotional Code:
Code owner:

GreenLanguages - Girona, 38 - 08010 Barcelona (Spain)
tel.: +34 93 302 36 64 — info@greenlanguages.com
© Green Languages 2003-2010 General Conditions