REGISTRATION FORM:

Please fill out this form and send it to us. A nonrefundable registration fee of U.S. $70.00 is required.

My name:

My address:

City:

State:

Postal Code or Zip:

Country:

Telephone: (area code):

Fax: (area code):

E-mail address:

Occupation / Beruf:

Age / Alter:

Level / Niveau / Stufe:

Beginner

 

Intermediate

 

Advanced

How long are you going to study at Becari / Duree / Dauer: months weeks

Program:

Regular

 

Intensive

 

Super-Intensive

Date you wish to start:

Do you need accomodation?

Date you will arrive:

If you want to live with a family:

 

Pets

 

Children

 

Vegetarian

 

Allergies

 

Smoking

Other Information:

Please bring two pictures 3cm x2cm aprox.
in order to receive a student's identification card