International Language Summer Camp - July 1st thru August 4th, 2012

Name

Surname

Gender: M F

Address

Postal Code

City

State

Country

Telephone

E-mail

Passport Number

School

Birth Date (DD/MM/YYYY)

Lacunza-IH student? no yes

Shirt size (y=youth, a=adult) y-S   y-M   y-L   a-S   a-M   a-L

Tutor´s name

Tutor´s surname

Tutor´s passport number

Tutor´s telephone

Language to learn choose one spanish english

Language level choose one beginner elementary intermediate advanced

Type of course choose one half day day camp overnight

Number of weeks choose one 2 weeks 3 weeks 4 weeks 5 weeks

Course date from (DD/MM/YYYY)

Course date to (DD/MM/YYYY)

Hire daily bus: no yes

morning noon afternoon

Choose your stop: Plaza de Guipúzcoa     Pío XII     El Antiguo

Transfer airport-campus
starting at 30 €   (view prices) no yes

Arrival date (DD/MM/YYYY)

Arrival place choose one San Sebastián Bilbao Biarritz

Flight number

Arrival time

Transfer campus-airport
starting at 30 €   (view prices) no yes

Departure Date (DD/MM/YYYY)

Departure place choose one San Sebastián Bilbao Biarritz

Flight number

Departure Date (DD/MM/YYYY)

Cancellation insurance:
12 € no yes