Student Information

PLEASE FILL IN THIS FORM IN ENGLISH AND IN CAPITAL LETTERS

Student's Name (required)

Student's Surname (required)

Student's Phone Number

Birthday (required)

Email

Address (required)

Postcode (required)

Town (required)

Father's Name and Surname (required)

Father's Telephone (Please fill in when student is under 18)

Email (Please fill in when student is under 18)

Mother's Name and Surname (required)

Mother's Telephone (Please fill in when student is under 18)

Email (Please fill in when student is under 18)

Student's Primary Language (required)

Student's Secondary Language

Please note whether the student has a condition that we need to be aware of (If applicable)

Please note if there the student has learning problems and clarify(if applicable)

With my signature, I agree to include the registered student in any publication and/or other productions, which aim to promote Potenzia del’ arte, without any demand.

I accept all terms and conditions of the school.