On-line Application Form

Ok! You are ready to enrol at our courses simply filling the form below.
After receiving your application, we will contact you by e-mail for confirmation.

If for any reason the form does not work, or you have not been contacted from us after several days from your sending, please e-mail us to info@spoletium.com

For any questions, enquiries, etc. please fill the inquiry form.

ON-LINE APPLICATION FORM

Basic Information

♦ Family Name
♦ First Name
♦ Sex	Male Female
♦ Date of Birth	(4 digits : dd/mm/yyy)
♦ Occupation
♦ Nationality
♦ Mother Tongue
♦ Postal Code
♦ Address1
♦ Address2
♦ Country
♦ TEL		♦ FAX
♦ E-mail

Course

♦ You can choose 1 or more courses at the same time. Please tick all the courses you hope to take, and select the lenght.
	Italian Language Course
Starting from:		(4 digits:dd/mm/yyy)~	Term

	Private Lesson
Starting from:		(4 digits : dd/mm/yyy)~	Term

	Cooking Course
Starting from:		(4 digits : dd/mm/yyy)~	Term

♦	Lerning experience of Italian Language Lesson

♦	Where did you learn Italian language?

♦	How long did you learn Italian language?

Accommation

	Homestay	Type
	Apartment	Type
	Hotel	Type
	Agriturismo	Type
Request about accommodation & ingredients of meals (ie. vegitalian, allergies, religion, e.t.c.) Also if you have a specific request about accommodation, please write down here.

Pick-up Service

If you request a pick-up service, please let us know the exact arriving date, time, and the flight number, if you arrive by a airplane, 3 day before your arriving.

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