*Full name:

Sex: M F

Date of Birth:

Profession:

Your address:

Your city:

State:

Country: Zip code:

Phone: Fax:

*E-mail address:

How did you find ABC school:

* Required fields

Course

Kind of course:

Starting date:

How many weeks:

Your level of italian language Select level of Italian None Some Average Good

Kind of accommodation Choose accomodation Single room Single + B&B Single + Half board Double room Double + B&B Double + Half board Studio apartment Apartment Hotel single + breakfast Hotel double + breakfast other (specify)

Transfer: Yes No

Payment

• CREDIT CARD NUMBER (please insert only the first 3 series -12 numbers- and send the remaining form in later mail)
  

Expires month year

• BANK TRANSFER

Scuola ABC
Cassa di Risparmio di Firenze
AG 17
Via dei Martiri del Popolo 35/39r
50122 Firenze
Account Holder: L'Arca s.r.l
Account number: 9500/00
ABI: 06160 CAB: 02817
IBAN: IT51LO616002817000009500C00
BIC or SWIFT: CRFI IT 3F
(please fax us a copy of your payment -
school fax 0039 055 212112)

Privacy

I authorize the ABC - SPM to include my personal data on a mailing list for the purpose of enrolment. I may also, periodically, receive informative, publicity or promotional material.

I may at any time, in accordance with Italian law (art. 13, 675/96), request that my personal data be removed from the mailing list of the School, by sending a written request by email, fax or priority mail.