お申し込み – speakeasy-cologne

受講をご希望の方は、以下の書式に必要事項をご記入の上、送信ボタン（Submit）を押して、　　　　　　　お申し込みください。お申し込みを受領後、確認メールを送付します。お申し込みには拘束力があります。

受講料が本校の指定口座に入金され次第、お申し込みが完了した旨を通知する確認書と必要書類を　　　　　　お送りします。

MrMrs
Last name *

First name(s) *

Tel. mobile:

Tel. land-line:

E-Mail address *

Date of Birth *

Nationality *

Passport number

Address

Street + House No *

City *

Postal Code *

Foreign address – Home address (in case of visa)

House no.

Street

Postal code

City

Country

I hereby register myself for the following language course:

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Course level *

Intended Starting-Date *

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Comment

The Terms of Service are incorporated into this contract. Signing this contract confirms that the student has read and accepted the Terms of Service. *
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