Registration Form - Accommadrid

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Accommadrid
C/ Rodríguez San Pedro 2. 6 planta oficina 608
28015 Madrid
Tel: 00 34 91 4488780
Tel-Fax: 00 34 91 4454352
e-mail: info@accommadrid.com
web: www.accommadrid.com

REGISTRATION FORM

Name
Last Name
Address in your Country
Postal Code
Phone Number
Nationality
ID-Passport
Sex	*Male* Female
Date of Birth	/ /
E-mail

ACCOMMODATION

	Single Room	Double Room	Use of Kitchen	Half Board	Full Board
Host Families	1	2	3	4	5
Residences	6	7	8	9	10
Flat Share	11	12	13	14	15
Bedsits	16	17	18	19	20

Other Options/ Specify

SPANISH CLASSES

Intensive Course

Super-Intensive Course

Special Course

OTHER INFORMATION

Do you like pets?	Yes No
Do you smoke?	Yes No
Are you allergic to anything or do you have any illness?
How did yopu hear about Accommadrid?	Press Friends or Relatives Internet Others

DAY OF ARRIVAL
/ /

ARRIVAL TIME

LENGTH OF STAY
From / /
Until / /

WHERE DO YOU ARRIVVE?
Train Station
Airport

WHY DO YOU COME TO MADRID
Study
Training in a Company

Specify address or area in Madrid where the school , university, company are located