First name:
Surname:
Full Address:
Town:
Country:
Zip Code:
Telephone:
Fax:
Email:
Date of birth:
Nationality:
Occupation:
Mother tongue:
Other languages known:
   
KNOWLEDGE OF ITALIAN
 
none basic intermediate good very good
   
Studied when and where:
 
years: months: hours/day:
 

I would like to enrol in the following course:
 
GROUP COURSES
 
EG/40 - BASIC INTENSIVE COURSE
EG+I/5 - COMBINED COURSE
EG+I/10 - COMBINED COURSE
EC/20 - CONVERSATION COURSE
 
from: to: weeks:
 
SPECIAL COURSES
 
  • ES - LANGUAGE & SPORT:

Italian & Kayaking
Italian & Mountain Biking
Italian & Trekking
 
from: to: weeks:
ED - ITALIAN & DRAWING FROM NATURE
 
from: to: weeks:
E50 - 50 PLUS COURSE FOR EVERGREENS
 
from: to: weeks:
 
INDIVIDUAL COURSES
 
EI - ONE-TO-ONE
       
Lessons/day: from: to: weeks:
 
ACCOMMODATIONS
 
I would like the following accommodation:
 
 
APARTMENTS (please specify for how many persons, how many rooms, price limit, etc):
 
Special notes concerning accommodation:
 
I am coming by car: Yes No
 
Please make a reservation for my car (ferryboat Piombino - Portoferraio - Piombino):
 
Model and lenght of the car: no. of passengers:
Day of arrival: time:
Day of departure: time:
 
I will pay the reservation/ticket in EUR cash upon arrival on Elba
 
Can we give your name to other students who would like a lift? Yes No
 
How did you find out about Centro Fiorenza?
 
Please send me your detailed brochure:
by e-mail
by mail
 
 
Send