Application

Application

Please fill out the following form to enroll in one of our Spanish language courses. If you only wish to receive information, to download our brochure or want us to call you use our contact page

To book standard courses please use our online booking tool HERE

All fields with an * have to be completed.

Personal Data

First Name *			Year of birth *
Family Name *			Gender *
Company			Profession
Street			Nationality
Zip / City			Spanish knowledge
State/Province			When and how did you learn Spanish? (nº of lessons, course and school type, etc.)
Country *
E-mail * (please double check!)			What contents have you studied
Phone
Fax

Course (s)


Type of course	Description
Brush up Course	20 Spanish lessons x 50 min./week
Express Course	30 Spanish lessons x 50 min./week
Conversation Course	10 Spanish lessons x 50 min./week
DELE Preparation	30 Spanish lessons x 50 min./week
Erasmus Course	20 Spanish lessons x 50 min./week
Advanced conversation evening course for residents in Madrid	2 Spanish lessons x 100 min./week
Spanish language beginner courses for residents in Madrid	2 Spanish lessons x 100 min./week

Accommodation

(for description and prices go to: accommodations

I require an accommodation: yes no

Please indicate the code name(s) of your favorite accommodation:
1:	2:	3:

Or indicate your lodging options:

apartment (550 - 2730 EUR/2 weeks) -->	My max. price: (EUR)
shared (234 EUR/2 weeks)	private bath (+88 EUR/2 weeks)
family (385 EUR/2 weeks)	private bath (+62 EUR/2 weeks)
hotel (572 - 1885 EUR/2 weeks) -->	My max. price: (EUR)

Arrival day: Departure day: Airport pickup (+75 EUR)

I am a: Non smoker Smoker

I mind living with smokers: Yes No

Additional comments

Payment (for the advance 180 eur.)

(for the advance payment of 180 EUR)
I would like to pay by: *
(In case of money transfer, please send receipt by fax to +34-914 324 541)
Credit card nº:
Exp. date:
Name on card:
I prefer to give my credit card information by phone or fax

I accept the prices *	yes
I accept the conditions *	yes

How did I hear about =elemadrid=
Further Remarks

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Dates: language classes Italy: iraly references Germany: german reference Austria: austria Business Spanish: spanish for business Spanish by e-mail: study spanish Flat sharing: 105 Dates 2011: language courses in madrid Spanish courses: spanish language courses Terms & Conditions: training program in spain

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=elemadrid=
Spanish for professionals, executives and demanding adult learners
Serrano 4, 28001 Madrid, Espagne
Tel. +34-91-432-45 40 | Fax: +34-91-432-4541
mail@elemadrid.com

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