RESERVATION AND BOOKING FORM FOR SPANISH LESSONS Our information is a complete as we provide, your signature on this form is a agreement to these documents. PERSONAL INFORMATION: Name : ----------------------------------------------------------------------------------------------------- Passport : ----------------------------- ------------------------------- ---------------------------- Address : ------------------------------------------------------------------------------- Telephone Nº :------------------------------------- Fax Nº:----------------------------- E.Mail Address : ------------------------------------------------------------------- Date of Birth: ------------------------------------------- Sex: --------------------------------- Marital Status: ------------------------------------------ Nationality: ------------------------ Any medical condition/ history/ disability/ dietary requirements that we should be aware of? --------------------------------------------------------------------------------------------------------------
Name and current contact details of a person to contact in case of emergency: -------------------------------------------------------------------------------------------------------------- About ELC please tell us when and how you discovered ELC? I, e, ad in newspaper/ magazine/ guide book/ friend/ hotel/ other? ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ABOUT THE PROGRAM: Total Number of Days: -------------------------- Start Date: ---------------------------------------- End Date : ------------------------------------------ PROGRAM COST: -------------------------- (Personal Expenses) If “Yes” to any of above, please supplies details:
Date :------/-------/------------ ----------------------------
BOOKING CONDITIONS:
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ADDRESS
Europe Language College - Spanish School
Av Francisco Solano 308, San Carlos , Huancayo, Peru - South America