Student´ File nº:

Cliente code:

Registration Form
April 2021

Personal Details (*mandatory)

First Name * Middle & Surname*
Please write exactly as shown in your passport.

Identification Document’s type * ID Card Passport Birth certificate

ID number * (Please attach a copy)
Date of birth * Country of birth*
Mobile number * Phone number
Gender* Female Male Nationality*
Address*
E-mail address *
Please make sure that the provided email address is correct.
Actual profession:

Details of the general course

Please, Select the type and indicate level and number of the general course you want to enroll in:

o Extensive Modality face-to-face

Level:
o Extensive Modality online
Course number:
o Intensive Modality online

Details of special course

Please, indicate type, level and the number of the special course you want to enroll in:
Type:
Level:
Course number:
I have read and accepted the Terms & Conditions of registration, the legal notice and the privacy policy of the
✔ Cervantes Institute https://www.cervantes.es/legal_notice_privacy_policy_en.htm and I authorize that my data be
processed by the Cervantes Institute, in order to provide me with the requested service, and send me information
related to that service.*

Legal note: https://www.cervantes.es/sobre_proteccion_datos_rgpd_adicional_prestacion_servicio_y_consentimiento_instituto_cervantes_en.htm

I want to receive information about the Cervantes Institute, its activities, objectives and products.

Date: Signature: