Madrelingua Italian courses in Bologna

Please complete this form first, then print it and fax it to: 00 39 051 267 822. Go back to payments page.

BOOKING FORM

1.Personal details and contact information

Surname Names

Date of birth: / /

Male: Female:

Address line 1
Address line 2
City                 State/province  
Postal code        Country  

Telephone
Fax            
E-mail 1    
E-mail 2    

2. Your knowledge of languages

What is your mother tongue?
What other languages do you speak?
When I start the course my level in Italian will be:
A1 - No knowledge of Italian
A1 - Very little knowledge of Italian
A2 - Basic knowledge of Italian
B1 - Relatively good knowledge of Italian
B2 - Good knowledge of Italian
C1 - Very good knowledge of Italian
C2 - Excellent or nearly native speaker knowledge of Italian

When we have received your booking we will e-mail you a level test so we can be sure to place you in the correct class on the first day of your course.

3. Your Italian course

I would like to register for the following course:

- General Italian (mornings - 20 hours a week)
- Intensive Italian (mornings and afternoons -30 hours a week)
- Individual lessons Please specify the number of hours per week

Course length 1 week2 weeks3 weeks4 weeks

other, please specify

First day of course: / /
Last day of course: / /

4. Your accommodation

Host families for homestay are carefully chosen by our staff, and live either in the centre of Bologna (walking distance from the school) or within an easy bus-ride (maximum 20 minutes). Homestay prices exclude meals because most students prefer to eat out during their time in Bologna. However, you may use the kitchen by arrangement with the homestay family.

Homestay single room
Homestay shared room
1 star hotel 2 star hotel 3 star hotel 4 star hotel 
Self-contained apartment/studio
No accommodation arrangement necessary thank you!


The following details will help us choose the correct accommodation for you:
Smoker Non-smoker:

I would prefer no pets I like animals!

Date of arrival: / /

Date of departure: / /

5. Other information

How did you hear about our Italian courses?

Internet Personal recommendation Other Please specify 

6. Protection of personal data

I give permission for Madrelingua S.r.l. to retain and use my personal data for the purposes detailed on this form  

I do not give permission for Madrelingua S.r.l. to retain or use my personal data for the purposes detailed on this form 

SIGNATURE                                                        DATE

(WARNING: your booking CANNOT be processed if you do not give permission)

When you have sent us your booking information, please click on this link to arrange payment of the course/accommodation deposit using a credit card or via a bank transfer GO TO PAYMENTS PAGE.