1

Personal Data

First name *

Surname *

Date of birth

Nationality

Passport number

Phone number

E-mail *

Occupation

Studies

What do you do in Barcelona?

* Fields required

2

Your course at Escuela Mediterraneo

Date of start

End of course date

Number of weeks or months

Type of course

--Hours for week-- 4 hours / week 8 hours / week 10 hours / week 12 hours / week 16 hours / week

Private classes

Hours

3

Your level of Spanish

Have you studied Spanish before?

Yes No

(If the answer is yes):

When?

For how long?

Where?

4

How did you hear about us?

• Website - Which one?
• An advert in the street
• An advert in a magazine - Which one?
• Recommendation by friends
• Others (What exactly?)

5

Why did you choose Escuela Mediterráneo?

• Recommendation
• Quality
• Location
• Timetables
• Price
• Courses' variety
• Other

6

Do you need to apply for a student visa?

Do you need to apply for a student visa?

• Yes, (please, read the information and conditions for students' visa applicants)
• No

7

Do you need accommodation?

If you need the accommodation certificate to obtain the visa you need to reserve an accommodation with us.
Do you need accommodation?

• Yes
• No