Enrollment Request

ENROLLMENT REQUEST


Enrollment Request
* obligatory filds



Nominativo:
Name *


Surname*




Address:
Street*


City*


Postal Code*


Country*



email:*


Contact telephone number:
Home*


Mobile*




Name of the course:*


Starting date*




Rules :*
Declares to have read and accepted the rules of Accademia Italiana




Notes:






Does the student intend to use the accomodation arrangements?:
yes no

If the answer is yes, please indicate the kind of accomodation preferred:
Room in student apartment
preferably single room   preferably double room  


How did you hear about the Accademia Italiana?





What level of studies have you completed?*





The student authorizes the Accademia Italiana to communicate to third parties his or her personal date for academic
necessities and in the fulfillment of the obligations of Italian Law 196 del 30/06/2003. *
I agree *