Booking for a course in a language other than German

Thank you for your interest in ESL PROLOG Berlin's language course. Please complete this form as precisely as possible so that we can authorise your order.

I would like to make a firm reservation for a foreign language course:


Language*:

Type of Course*:
  • In order to book individual tuition
(one-to-one lessons), please click here!

Level*:

Start Date*:

Duration*:


My knowledge of this language:

Self Evaluation*:
I have learnt this before
- for how long?

Comments:


Personal Data:


Title:  Ms   Mr
First Name*:
Surname*:
Birth date*: (Day, Month, Year)
Native Language*:

Country*:
Post Code*:
Town*:
Street*:

Telephone:
E-Mail*:

I have read and accepted the •Terms & Conditions

Agreement:

The registration cost is: 12,50 €
My place on the course will be resevered as soon as my payment of 50 €
has been recieved by IH Berlin PROLOG (•Our Bank Details).

   
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ESL PROLOG - Berlin • D-10827 Berlin • Hauptstraße 23/24

+49 30 7811076 • City Map & Route Planner

ESL PROLOG - Berlin
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