Registration Form 14th CEMS Spanish Summer School 6th July - 24th July 2015 PERSONAL DETAILS First name: Surname: Passport number: Date of birth: Nationality: Mother tongue: Email: Phone number (country code included): Address: City and state/province: Postal code: Country: Home university: CEMS Coordinator: ACCOMMODATION: I will make my own accommodation arrangements. I need assistance* with accommodation and prefer the following options I would like to share a flat; I would like homestay accommodation with cooking facilities; I would like to stay in student Halls of Residence. *Altiro (www.altiro2000.com), our recommended housing agency, will contact you to arrange accommodation. Registration deadline: June 15th, 2014. METHOD OF PAYMENT (credit card only) Course fee: € 1.150 Please note: Registration is not complete until the entire tuition fee has been paid. It will be charged after your admission process has been approved. Visa MasterCard American Express Card number: Expiry date: / CVV Cardholder’s name: ADMISSION PROCESS: To be accepted on the course you will have to do a written test and an oral interview. After receiving this registration form we will contact you to give you the necessary information for the written part and to schedule the oral interview (by Skype or phone). Place and date: Please return the completed Registration Form by email to: [email protected] More information at: www.esade.edu/summer-school/eng/ ESADE LANGUAGE CENTER Av. d’Esplugues, 92-96, 08034 Barcelona Tel. +34 934 952 095 Health insurance STUDENTS FROM EU COUNTRIES: If you are covered by your country’s national insurance system, you should request an E111 Form, which entitles you to free medical assistance under the Spanish public healthcare system. If you are covered by private insurance, consult your insurance company regarding medical assistance while in Spain. Please request full information about the procedure to follow should you need medical assistance. STUDENTS FROM NON-EU COUNTRIES: Private insurance to cover medical assistance in Spain should be arranged.
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