Learners of German wanted!

I would like to book the following training course:

Course*:

please select 01.09. - 12.09.2008 (2 weeks) 01.09. - 26.09.2008 (4 weeks) 15.09. - 26.09.2008 (2 weeks) 03.11. - 14.11.2008 (2 weeks) 03.11. - 28.11.2008 (4 weeks) 17.11. - 28.11.2008 (2 weeks)

My knowledge of German:

Self assessment:

please select no very little little moderate good very good almost perfect

If you have taken our • Online Test, which test levels did you reach at least 80%?

Test level A1
Test level A2
Test level B1
Test level B2

I have already studied German:

please select never before at school at university at a language school

-Course length:

please select 1 2 3 4 5 6 7 8 9 10 11 12 weeks months years

Your accommodation in Berlin:

Preferred accommodation:

please select no accommodation single room with self-catering single room with breakfast single room with half-board double or twin room with self-catering* double or twin room with breakfast* double or twin room with half-board* single room double or twin room*

*Double or twin room,
sharing with:

If the accommodation I have selected is not available, I would like:

please select no accommodation single room with self-catering single room with breakfast single room with half-board double or twin room with self-catering* double or twin room with breakfast* double or twin room with half-board* single room double or twin room*

Do you smoke?

 Yes   No

How are you travelling to Berlin:

Date:

01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 01 02 03 04 05 06 07 08 09 10 11 12 2008 2009

Transfer:

please select no thanks only when I arrive  +60€ arrival and departure  +90€

Which airport or
train station will
you be arriving at?

Flight/Train number:

at o'clock

Comments:

Personal Details:

Title:

 Ms.   Mr.

Name*:

Native language*:

Country*:

Zip/Post Code*:

City*:

Street*:

Phone:

Age:

please select 16-17 Years 18-20 Years 21-25 Years 25-35 Years 35-49 Years 50+ Years

e-mail*:

* Required fields

I have read and accept the • Terms & conditions.

A place on a course will be reserved for me as soon as my
advance payment of € 150 reaches IH Berlin PROLOG. (• Bank details)

Ihre Bankverbindung wird benötigt für die
Rücküberweisung bei regelmäßiger Teilnahme.

Bank:

Account holder:

Account number:

Bank code:

SWIFT/BIC:

IBAN: