Enrollment Request

Nominativo:
Name *


Surname*

Address:
Street*


City*


Postal Code*


Country*

email:*


Contact telephone number:
Home*


Mobile*

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 n. 675 of 31/12/96. *
I agree *