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  18 May 2012 | 17:28 (5:28 pm)

Application Form Heidelberg

 
Please provide the following information:

Title:      
First Name:   Nationality:
Last Name:   Place of birth:
Street Address:   Date of birth:
City:   Profession:
State:   Native Language:
Zip code:      
Country:      
Telephone:      
Fax:      
Email:      
Confirm Email:      
         
 
 
 
Please indicate your language level in German:
 
Absolute Beginner    
Elementary    
Intermediate    
Advanced    
         
How long and how intense have you studied the language and where?
   
Which teaching material have you used to study German?
         
 
Please choose your language course:
 
Language course:
 
Register for Language Examinations:( Optional )

Choose Language Exam

Exam Dates
 
 
 
Accommodation:
 
         
Do you require accommodation?
If yes, which type?
         
Smoker? Yes No
         
Allergies? Yes No
         
 
Comments:
   
Special offers:

 
 
 
Do you require airport transfer?
 
Departure:      
Arrival:      
         
Arrival detail to be given later
   
   
Person to contact in case of emergency:
   
First and Last Name:
Relationship:
E-mail address:
Phone Number (Home):
Phone Number (Other):
Fax Number:
   
   
How did you hear about IH-Heidelberg Collegium Palatinum? *

Please describe how:
   
Further comments:
   
 
Application and payment conditions
 

One-time registration fee: € 45

Upon receipt of an application form, ih Heidelberg - Collegium Palatinum sends a written confirmation of the student's acceptance. To confirm registration, the student (or her/his parents if she/he is a minor) needs to transfer a non-refundable tuition deposit of € 200 (plus € 200, if accommodation is also required), which will be deducted from the course fees. The balance listed in tbe acceptance letter should be paid no later than 30 days before dasses begin. Late registrants will have to pay the total course fee upon receipt of the acceptance letter.

The estimated fee and dates listed above are subject to error or change. Course fee payments are in EURO / €. Only the amounts indicated on the invoice issued by the school are official and binding.

If you wish to receive the confirmation by courier, please arrange for a courier to pick up the confirmation at ih Heidelberg - Collegium Palatinum and inform us in due time so that the documents are ready for pick-up at the reception (open hours: 8.00 a.m. - 17.00 p.m.).

All fees may be paid by check, bank transfer or credit card, whatever is convenient for you:

   International bank coordinates:

  • H+G Bank Heidelberg Kurpfalz e G    
  • BIC: GENO DE 61 HD3                  
  • IBAN: DE76672901000040029028 

      Address of the bank: Hauptstrasse 46, 69117 Heidelberg, Germany  Tel: + 49 (0)6221 9090

   Bank coordinates for Germany:

  • H+G Bank Heidelberg Kurpfalz e G
  • Bank account number: 40029028 
  • Bank code: 67290100    

If cancellations are made more than 30 days prior to the start of the course, ih Heidelberg - Collegium Palatinum will refund the total amount less the non-refundable deposit, which can be credited towards a future course within the next 2 years.

No refund is given to students who leave before the end of their course or miss classes. This does not affect a participant's right to extraordinary cancellation. In matters of accommodation, ih Heidelberg - Collegium Palatinum only acts as an intermediary between students and landlords and cannot be made responsible for their relationship.


ih Heidelberg - Collegium Palatinum reserves the right to adjust prices, dates or course specifications without prior notice.

* With less than 3 participants the amount of lessons will be reduced as follows:

  • With 2 participants 50 % of booked lessons
  • With 1 participant: 30 % of booked lessons on one-to-one basis

Third person liability:

Irrespective of the legal justification, the liability of ih Heidelberg – Collegium Palatinum is limited to intent and gross negligence. ih Heidelberg – Collegium Palatinum does neither accept liability for any accidents that may occur during, on the way to and from an event nor for theft, loss or damage of property; the same applies for events offered for children and teens.
Participants are held directly liable for any damages caused to a third party.

   
All of the information above is up-to-date and correct.
I have read the application and payment conditions and I accept them:
 
 
To process this application please click "send":
 
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