Enrolments

Instructions

Please complete the form and hit the “Submit” button. Mandatory fields are marked with an asterisk (*).

First Name (required)*

Last Name (required)*

Your Email (required)*

Enter Email Confirm Email

Telephone:*

Date of Birth:*

ID / Passport No.*

Tax Number

Address:*

Country:*

Gender:

Native Language:

Choose the Language you wish to learn*

Enrolment preferences*

Modules*

Current language level:

Start Date: (dd/mm/yyyy):

End Date: (dd/mm/yyyy):

Total number of weeks:

How many hours per week?:

How did you hear about ALM?:

Further Informations, Availability and Preferences

Payment option

Make payable to ACADEMIA DE LÍNGUAS DA MADEIRA BANCO SANTANDER TOTTA SWIFT CODE – TOTAPTPL IBAN – PT500018 0000 0616 9892 0018 4

The course fee is to be paid before the start of the course. It can be paid upon arrival on the first day.

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