Name *

Surname*

Sex
MaleFemale

Knowledge of Italian language

NOTHINGA1A2B1B2C1C2

Your mail *

Nationality

Birth date (gg/mm/aaaa)

Birth place

Address

City

Zip code

State

Phone Number

Mobile phone

Occupation

Identification Document

Document Number

Name of the course you wish to follow

Starting dates for Absolute Beginners:
(Courses start every Monday for the other levels)
22 January05 February04 March08 April22 April06 May20 May03 June17 June01 July15 July05 August19 August02 September16 September07 October21 October04 November18 November02 December

Starting date

Choose the accomodation:

Student ApartmentFamilyHotelCamping

Number of weeks

Account of Euro 155,00
by bank transfer to the following Bank details of Tiberius International:

c/c n. 601470
addressed to Tiberius International
BANCA POPOLARE DELL’EMILIA ROMAGNA
AGENZIA N.1
VIA CADUTI DI MARZABOTTO 47 - RIMINI – ITALY
IBAN IT98P0538724202000000601470
SWIFT BPMOIT22
BIC BPMOIT22XXX

Special requests

Privacy: In accordance with Legislative Decree no. 196/2003 is that the information provided at Tiberius International, will be handled in writing and / or paper, magnetic, electronic or computer in full compliance with those regulations.

I have read and I agree the regulation of Tiberius International