REGISTRATION FORM - LANGUAGE COURSES REGISTRATION FORM - SPANISH COURSE
 
*Surname *Name
Sex M F
*Address
*City *Zip code *Country
*Nationality *Passport number
*Phone Mobile Fax
*E-mail Date of birth / /
Ocupation Work number
 
INVOICE
Full name : No. I.D.:
Address: Z.C.: Country:
 
SELECTED LANGUAGE LEVEL
ENGLISH
Basic
Elementary
Pre-Intermediate
Intermediate
Advanced
FRENCH
Basic
Elementary
Intermediate
Advanced
CHINESE
Basic
Elementary
Intermediate
Advanced
JAPANESE
Basic
Elementary
Intermediate
Advanced
Superior
CATALAN
Basic
Elementary
Intermediate
Advanced
   
SELECTED COURSES  
COURSES 2 HOURS Days: Hours:
COURSES 3 HOURS M-T W-Th F Hours:
1-ON-1 CLASSES Nº of hours Hours:
COMPANIES
INTENSITY SUMMER   Hours:
Starting Date / / Date order / /
Observations
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METHODS OF PAYMENT
CASH PAYMENTS
 
EFT. Bank account details:

Pylmon Languages s.l.
Bank: La Caixa
Account Number: 2100 - 2878 - 66 - 0200714710
IBAN: ES77 2100 2878 6602 0071 4710
BIC code (SWIFT): CAIXESBBXXX
Dirección: Av.Diagonal, 431 bis - 08036 Barcelona
*All bank fees are charged to the student. Please send a copy of the transfer with your name to the fax (+34)933178192 .
 
VISA CARD o MASTERCARD (other cards are not accepted) send authorization signed by fax to (+34)933178192.

Information to be provided: Cardholder - Passport - the card number (16 digits) - Expiration Date (month / year) - Total amount approved and authorized signature. Download the document
 
* I have read and accept the general conditions of Pylmon Languages
 
 
Pylmon Languages C/ Pau Clarís 89 Entlo. 2ª Barcelona (España) Tel. (+34)933013532 Fax.(+34)933178192