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PERSONAL DETAILS

Name *

Surname *

Date of birth *

Nationality *

Passport number *

Profession

Sex *:Male Female 

YOUR SPANISH COURSE

Type of course:

Course starting date:

From:

Until:

Specify your level of Spanish:

Tell us briefly your experience with learning Spanish so far:

YOUR ADDRESS

Street + number *

City *

Country *

Telephone

Email *

YOUR ACCOMODATION

Type Accommodation:

Accommodation dates:

From:

Until:

Comments:

OTHER INFORMATION OF INTEREST

Do you smoke?*: Yes No 

Do you have any food allergies?

Do you have any special dietary requirements?

Do you have a problem living with cats, dogs or other animals?*: Yes No 

Do you have any illness or medical conditions?

Are you currently taking any medications? If so what?

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