PERSONAL DATA

Name, Surname	Sex
	M:   F:

Place and date of birth	Nationality

Address	City

State	ZIP

Country	Telephone number

Fax number	E-mail

Occupation

Message or additional requests

BOOKING DATA (PERSONAL DATA IS REQUIRED)

Specify course

I wish to follow the course in:      Rimini:     Bologna:    

Period from	To

Identity document type and number	Expiry date

Knowledge of Italian: None:    Beginner:    Intermediate:     Good:     Advanced:

Deposit paid by (* read the notes)
	International postal money order
	Eurocheque
	Bank transfer account #601470 Payable to: TIBERIUS INTERNATIONAL SWIFT BPMOIT22 Banca Popolare dell'Emilia-Romagna RIMINI - Agenzia di cittą 1 Via Caduti di Marzabotto, 47 - 47900 Rimini - Italia
Deposit paid on date:
Accomodation: Student apartment:   Local family:   Hotel:

    

NOTES:

-	The deposit is of LIT 200.000
-	Bank charges at the expense of the sender
-	The outstanding amount must be paid on the first day of the course

GENERAL CONDITIONS:

-	Students under 18 years of age must submit a letter of permission from their parents
-	Cancellation must be made by means of a registered letter at least 30 days prior to commencement of the proposed course. Failure to do this will result in loss of deposit
-	No refund for delayed start or earlier departure
-	The school acts as intermediary between students and landlords and can not be responsible for relations between them. The school is not responsible for illness, accidents, theft or loss of personal goods either by the school or the accommodation hosts. We therefore recommend to effect a personal insurance policy.

    

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TIBERIUS INTERNATIONAL
Palazzo dei tre re - C.so d'Augusto, 213 - 47900 RIMINI - ITALIA
tel. 0541.23292 / 0541.708211 - Fax 0541.23292
e-mail: tiberius-international@infotel.it
Web site: http://www.infotel.it/tiberius-international