You can print off the form and sent it back by fax or else you can register on the Internet using the form below and clicking on “Send”.
	Please send me your brochure with current prices.
	Male Female *Surname *Name *Street *Region *Country Date of Birth Telephone Fax *Email
	The fields marked with an asterisk * must be completed.
	My knowledge of the Italian language is: Nil Slight Some Average Good Excellent
	Have you learnt / studied Italian in the past?
	No. Yes, hours per week for years.
	Why do you want to improve your Italian? work study hobby
	Where did you learn about our school?
	Friends, word of mouth Embassy ENIT University Institute of Culture Announcement in other Article in
	A Conversation Course (2 hours per day / 5 days per week)
	2 weeks / 20 hours 6 weeks / 60 hours 4 weeks / 40 hours 8 weeks / 80 hours
	B General Course for small group (4 hours per day / 5 days per week)
	1 week / 20 hours 8 weeks / 160 hours 2 weeks / 40 hours 12 weeks / 240 hours 3 weeks / 60 hours 16 weeks / 320 hours 4 weeks / 80 hours 20 weeks / 400 hours 6 weeks / 120 hours 24 weeks / 480 hours
	C Intensive 20 + 6 Course (General Course + 6 private lessons)
	1 week / 26 hours 4 weeks / 140 hours 2 weeks / 52 hours 6 weeks / 156 hours 3 weeks / 72 hours 8 weeks / 180 hours
	D Two For One
	10 hours 20 hours 30 hours 40 hours 60 hours
	Start of Course End of Course
	E Private Tuition
	10 hours 20 hours 30 hours 40 hours 60 hours
	Start of Course End of Course
	Studio Flat SS* in 2-3 room apartment SD** ( together with ) in 2-3 room apartment 2 room apartment (for family and friends) Special Requirements Smoker No-Smoker (*single room) (**double room)
	Arrival by
	air train car bus
	Day of arrival: Sunday, the at o’clock. Leaving: Saturday (before 10 noon), .
	I would like you to book me an Alitalia flight or a charter flight from / to for Lamezia Terme. Number of air tickets I require transport from Lamezia airport the railway station . 2 transfers or 2 excursions Please let us know, with regard to the information provided, which is the best value flight and the best non-binding price.
	General Conditions for participation in the course 1. Confirmation: after receiving the registration for and deposit, we will send you a confirmation of your registration. 2. Registration: Deposit of 100,- € and a completed registration form sent via email or fax to the following address: Piccola Università Italiana Largo Antonio Pandullo 6, 89861 Tropea - Italien Tel: 0963 60 32 84, Fax: 0963 61 786 info@piccolauniversitaitaliana.com Your deposit can be paid in one of the following ways: - send a cheque by registered mail together with the registration form - send an International Money Order to the following address Piccola Università Italiana Largo Antonio Pandullo, 6 89861 Tropea (VV) Italia - by bank transfer 3. Cancellation conditions: Course Apartment Registration fee: 100 € 30% of the accommodation rate For cancellations that we will receive 3 days before the arrival: 50 % For cancellations that we will receive 30 days before the arrival: 50 % of the accommodation rate For cancellations that we will receive 1 day before the arrival: 100 % For cancellations that we will receive 7 days before the arrival: 100 % of the accommodation rate   4. Course Price: The full price for the course must be paid at the start of the course and will not be refunded in the event that the course is interrupted.
	I have read the conditions for participation in the course and fully accept them. Place/date Signature
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