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Please indicate your approximate level of Spanish: —BeginnerElementaryIntermediateAdvanced
Comments
Why would you like to study Spanish?
Please reserve me a place on the following course(s): From: To: Numbers of weeks:
I require acommodation provided by IH: Yes No From: To: Numbers of weeks:
Do you suffer from any allergies or other medical problems? Yes No
If yes, please specify:
Do you smoke? Yes No
Comments:
Flight Company: Flight N°: Arrival Time:
Train: Station: Arrival Time:
Other: Date(D/M/Y): Transfer requested (to and form Airport) Yes No
Do you need a medical insurance privided by our school : Yes
CashBank Transfer
Account Information: ih Madrid S.A., Banco Bilbao Vizcaya. Account Number: C.c.c. ES 43/0182 9050 16 0010047248. Bank Address: Calle Genova 6, Madrid 28004. Note: All bank charges should be paid by the student
Credit Card Type: N° Expiry date
YesI hereby state that I agree with the contract conditions of IH Madrid.
I heard about International House Madrid from: Agent Friends Web page Publicity Others
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