Secure enrolment form
This form is for language courses only.
Fill in this form and send it back to us. Thank You !


1. Personal details
First Name*

Family Name*
Date of birth  Day: ;    Month:  ;   Year (YYYY):
Male or female Male Female
Your language 
Nationality
Occupation
Home address in your own country
City
Zip Code / Postal Code
Nation
Telephone no.
Mobile phone no.
Fax no.
Email*
What do you think your level of Italian is? beginner, elementary, intermediate, advanced,proficiency
Your interest

 Emergency contact
  

 
2. Course details
Course start date  Day ; Month:; Year
End date   Day ; Month:; Year -     total number of weeks  
   
  Language courses
 
# A - Group courses
  Standard - 15 hrs per week of group course
  Intensive - 20 hrs per week of group course
  Super Intensive - 20 hrs of group course + 4 hrs of group conversation course per week 

# B - One-to-one course & Home tuition course
  Individual course in Siena 
Home tuition in Viterbo - Language program
  Home tuition in Viterbo - Language + Culinary program

# A+B - Combined courses
  Standard - 15 hrs of group course + 4 hrs of individual per week
  Intensive - 15 hrs of group course + 8 hrs of individual per week

# C - Long term courses
  Trimester - 12 weeks
  Semester - 24 weeks
  Academic year - 32 weeks

# D - Special courses
   German BU - (German people only)
   CSN - (Swedish people only)

 

  Art & Crafts
  Theatre course
  Internship
   Siena Magnifica - Indicated for seniors
  Discovery Siena

# C - PLIDA certificate
  No
  PLIDA preparation
  PLIDA Exam
     
 
   

Brief description about personal goals and why you want to take the course

 

 
3. Accommodation details
If you would like your accommodation to be arranged for you, select one of the buttons below. Otherwise select: I'll make my own arrangements

First choice accommodation
         Shared apartment 
Family 
Residence 
Private apartment 
Hotel - 2 stars ( ** ), 3 stars ( *** ), 4 stars ( **** )
Il Bareto - Country estate
I'll make my own arrangements

Second choice accommodation
(please select a different type of accommodation in case your first choice is not available)
  Shared apartment 
Family 
Residence 
Private apartment 
Hotel - 2 stars ( ** ), 3 stars ( ** ), 4 stars ( ** ) 
Il Bareto - Country estate
I'll make my own arrangements
   

Please check the statements that apply to you and write details in the comments field. Thank you!
 
Do you smoke? Yes No
Do you take medicine regularly? Yes No
Do you have any allergies? Yes No
Do you have any dietary requirements?

I'm vegetarian

 No
Do you like pets?

Yes

 No
Do you like children? Yes No

Please add any necessary details here

  
4. Transfer details
If you would like the school to arrange a transfer from the airport to your accommodation for you.
No, Yes
  
5. Other information

How did you hear about Soc. Dante Alighieri - Siena   
  
6. Payment

Applications should reach the school office at least 30 days before the beginning of the course together the deposit (30% of the TOTAL fee; course fee + administration fee + accommodation fee). In case of last-minute enrolment (less than 15 days of the beginning of the course) it is necessary to pay the total fee in full (sending us by fax/email copy of the bank transfer) or sending us credit card details in writing, authorizing us to charge the total fee immediately (in case of no show no refundable is possible.
Payment of the deposit / balance can be made by:  Bank transfer ,   Credit Card. 
  
7. Any additional comments & requires

I have read, understood and accept the terms and conditions of participation.



 

Gay friend

Società Dante Alighieri - Comitato di Siena
Italian language school in Italy - Italian cooking school - Italian language courses in Siena
Via Tommaso Pendola, 37 - 53100 Siena - Italy
Tel. +39 0577 49533 - Fax. +39 0577 270646 - 0646 - info@dantealighieri.com