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克拉高
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保留

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PERSONAL INFORMATION
First Name:
Last Name:
Gender:


Age:
Profession:
Nationality:
E-mail:
Re-type e-mail:

EMERGENCY CONTACT INFORMATION

Full Name:
Address:
Telephone:
E-mail:


ADDITIONAL RESERVATION FOR FRIEND OR FAMILY MEMBER
Full Name:
Full Name:
Gender:


Gender:


Age:
Age:
Profession:
Profession:
Nationality: Nationality:
Level of Polish:
Level of Polish:


PLAN OF STUDY

Start date:
Day: Month: Year:
How long would you like to study : weeks
Time of day:
Morning Afternoon Evening
Hours per week:
Level of Polish:
Program chosen:
Do you have any specific language requirements
(e.g. grammar, vocabulary, etc.)? If so, what?


LODGING

Would you like lodging?
If YES, where would you like to stay ?
If OTHER write your suggestion
if hotel would you like a private bath?
Do you have special dietary considerations?
What are they?
Dates you require lodging:
From:
Day: Month: Year:
To:
Day: Month: Year:


ARRIVAL

Transportation requested:
Arrival Date:
Day: Month: Year:
Airport:
Flight number:
Arrival time:
(hh:mm)


PAYMENT

Method of Payment:


ADDITIONAL INFORMATION

Complete all information - automatically be entered for a chance to win free week of deluxe accommodation and private lessons!

Date of reservation:
Day: Month: Year:
How did you hear of the school:
If Internet, which web site ?
If a web site, and you used a search engine to find it, which search engine?
What key words (or phrases) did you use when searching for a language school on an Internet search engine?
If you heard of us from a university, former student, or other, please list name here:
Additional comments:

Which factor or factors helped you choose ILC?
price
lodging options
apartments
reputation
study programs
ILC web site
administration staff
web site reference
search engine reference
friend or colleague recommendation
e-mail responses
ILC web site in my own language (other than English)
OTHER (please list):


I have read and agree to all of the general terms and conditions for International Language Centers



 

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