Enrolment form

STUDENT INFORMATION
Name and Surname
 Male Female
Date of Birth (dd/mm/yyyy)
 Passport n°
 Nacionality
Address
Postal Code
 City
 Country
Telephone
 E-mail
 Fax
COURSE INFORMATION
Knowledge of Spanish:
I would like to register in the following courses:
     
   
Courses dates (dd/mm/yyyy)
In Salamanca from to Weeks
In Seville from to Weeks
Notes
ACCOMMODATION INFORMATION
Homestay: Double Room Single room
  Full board Half board
Residence hall: Double Room Single room
  Full board Half board
Student flat: Double Room Single room
Private apartment: For one person For two person*
*Booking together
Accommodation dates (dd/mm/yyyy)
In Salamanca, from to Days
In Seville, from to Days
Do you have any special requirements with respect to your accommodation?
IN CASE OF YOU HAVE AN EMERGENCY DURING YOUR COURSE, WE MUST PUT IN CONTACT WITH:
Name and Surname
 Male   Female
What relation is this person to you?
Address
Postal Code
 City
 Country
Email
 Telephone
 Fax
How did you hear about Mester?
HOW WILL YOU PAY THE DEPOSIT?
Bank transfer. Date of the transfer
Postal order. Date of the postal order
Travel Cheque
International check
Credit Card*:
Visa Mastercard
*I authorised to charge my credit card the amount of 150 euros.
HOW WILL YOU PAY THE REST OF THE AMOUNT?
Bank transfer. Date of the transfer
Postal order. Date of the postal order
Travel Cheque
International check
Credit Card*:
Visa Mastercard
*I authorised to charge my credit card the amount of euros.