Personal Details Name of Course: and number of weeks How did

Please send the Enrolment Form to AIL Madrid
Personal Details
Family Name:
First Name(s):
Home Address:
Telephone:
Date of Birth:
Email:
ID/ Passport No.
Nationality:
Emergency Contact Details
Family Name:
First Name(s):
Relationship:
Telephone:
How did you hear about us?
Search Engine:
Former AIL Madrid Student
Advertisement (please specify): __________________________
Google
Yahoo
Agent (please specify): _________________________________
Other (please specify): ____________________
Other (please specify): _________________________________
Name of Course: and number of weeks
Accommodation:
Spanish host family
Individual
Double room*
Shared flat
Individual
Double room*
Student residence
Individual
Double room*
Hotel
3
4
5
I don’t need it
* Double rooms are only available to students on a group booking.
Please specify the person with whom you wish to share: ____________________________________________________________________
Arrival date: _________________________________________
Departure date: _________________________________________
Other Services
Airport transfer
Arrival only - 75€
Arrival and departure - 125€
Medical Insurance:
Yes
No
Please consult AIL Madrid for more details
Confirmation:
I have read and accepted AIL Madrid’s terms and conditions.
Signature:
Date:
Academia Internacional de Lenguas Madrid S.L - C.I.F. B84717180 - www.ailmadrid.com
Inscrita en el Registro Mercantil de Madrid, Tomo 22.813, Libro 0, Folio 11, Sección 8ª y Hoja número M-408343