Italian Language courses in Italy, Italian lessons in our schools of Bologna and Arezzo

Family Name	First Name
Sex	Date of Birth
Home Address	Town Zip Code
Country	Other
Phone Fax	E-mail
Profession Mother Tongue Other Languages

	How many hours?
	Starting date Number of weeks
Accommodation
in a room with bed/s room/s	I would like to share the room with
Competence of the Italian language How long have you studied? Where
Name of the School/Teacher/University
How did you first hear about the school Cultura Italiana? Which one?
Do you need a baby-sitter? Do you smoke? Do you have any allergies?
1. Do you have any specific interests for the program of after-class activities? 2. Do you have special request?
In order to validate the registration a deposit of Euro 130 is required
I would like to pay by	Visa, Mastercard In this case your enrollment will remain pending until the receipt of your deposit
School Procedures	I read and accept the school procedures

I agree to receive from Cultura Italiana information about their courses and initiatives and authorize the use of my data only for these purposes
Home	info@culturaitaliana.it

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