PERSONAL INFORMATION

MaleFemale

Surnames:

Name:

Date of Birth:

Age:

Nationality:

Occupation:

Passport number:

Telephone:

E-mail adress:

Address in home country

Street

Town or City

Poste Code

Country

FOR UNDER 18's

Father’s name:

Father’s telephone number:

Father’s email address:

Mother’s name:

Mother’s telephone number:

Mother’s email address:

Address in home country:

Street:

Town or city:

Post code:

Country:

In case of an emergency, Call:

ACCOMMODATION

Do you smoke? NoYes

Would you accept staying with a smoking family? NoYes

Do you suffer from an allergy? NoYes ; Give Details:

Do you have any medical treatment?: NoYes ; Give Details:

Would you accept staying with a family that has pets?: NoYes

Other requirements:

Date:

Student’s signature:

Father’s, mother’s or legal representative’s signature.

Enrolment Form

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Folleto Completo

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Poster in English

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Full Brochure

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Promotional Leaflet

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Poster in German

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