CSN APPLICATION FORM
Fill in this form and send it back to us. Thank You !


1. Personal details
 Mr. -  Mrs. -   Miss. -  Ms. 
Given Name

Family Name
Date of birth Your language 
Nationality Occupation
Home address
City Zip / Postal Code
State Nation
Telephone no. Fax no.
Email Knowledge of Italian : 
Your interest

 Emergency contact 
  
2. Courses 
Course start date
number of weeks
  
 
  
3. Accommodation
If you would like your accommodation to be arranged for you, select one of the buttons belows. Otherwise select: I'll make my own arrangements
         Shared apartment in double (included in the price)
 Shared apartment in single
Family in double
Family in single
Residence 
Private apartment 
Hotel - 2 stars
Hotel - 3 stars 
Hotel - 4 stars 
Il Bareto - Country estate
I'll make my own arragments
   

Please check the statements that apply to you and write details in the comments field at the end of this form. Thank you!
  I smoke
I don't like cats / dogs in my home
I can't eat some foods
I have religious observances
I have special medical problems
I would like children in my host family
  
4. Transfer

Do you require transfer ?  

Yes     No     

   Arrival location   
  
5. Other information
How did you hear about Soc. Dante Alighieri - Siena   
If you find us on internet / others, please specify where   
  
6. Payment

To be admitted into the course you will have to produce evidence of payment. The school will credit your account the net amount we receive in Euro, USD or SFR. Payment of the deposit / balance can be made by:   Bank transfer ,   Credit Card. 
  
7. Other information

 

By signing the registration form or any other written form of registration, the participant accepts the "General Conditions of Participation".



The student authorizes the Sienalingue srl (commercial management of Soc. Dante Alighieri - Com. Siena) to include her/his personal data on a mailing list for the purpose of enrolment. The student may at any time, in accordance with Italian law (art. 13, 675/96), request that her/his personal data be removed from the mailing list of the School.

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