Name:
Surname:
Address:
Nationality:
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Date of birth:		Tel.:
Fax:		E-mail
Chosen period
1 week 2 weeks 3 weeks 4 weeks more than 4 weeks
(from to )
Language-level
Absolute Beginner     Beginner     Elementary     Intermediate     Advanced
Courses
Standard course (S3) Intensive course (I4) Intensive course (I6) Intensive course (Ipiù) Individual courses Preparation for CILS examination Opera course Business italian courses Stage of Lyric Opera Summer Stage of Lyric Opera
Additional courses
no additional courses Italian cinema Italian cooking Italian art
Lodging
Room with use of the kitchen
Homestay		with breakfast half board
Apartment in "Agriturismo" (Farm house)
How long have you studied Italian?
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