Course registration - Deutsch-Amerikanisches Institut. Haus der Kultur.

Categories*
Adults
Course selection*
Children & Young people
Attention: the course rooms for the kids´ courses are (located) at Adenauerplatz 1 (the Deutsche Bank building) in 69115 Heidelberg. (With the exception of the holiday camp)
Course selection*
Holiday crash courses
Course selection*
Holidy camps
Course selection*
Number of days*
Desired date:
Date from*
Date to*
Title*
Name*
First Last
Name legal guardian*
First Last
Name of child / student*
First Last
Date of birth of the child / pupil*

DD
MM
YYYY
Address*
Street Address ZIP / Postal Code City
Phone number*
E-mail*
Class (2018 / 19)*
Grade*
School*
Payment*
- Payment method: cash payment (in the DAI One World Language School in Heidelberg, 2nd floor, Monday – Thursday, 9am - 12pm and 1pm - 3pm)
- Direct debit authorization
I hereby authorize the DAI Heidelberg to deduct the course fees by direct debit from my bank account. (German bank accounts only)
Account holder*
IBAN*
BIC*
*
- once per course
- until recalled
- I am a member of the DAI Freundeskreis and request for a 10% reduction.
  Please/ kindly enclose a copy of your member ID. (once per course/ until revocation)
Privacy*
- I agree that DAI Heidelberg will process and store my personal data for communication in the matter requested by me in accordance with the data protection declaration. A forwarding to third parties does not take place. I can revoke my consent to the use of my personal data at any time with immediate effect.
In submitting this application, I accept the general business terms of the DAI in Heidelberg. These can be found on: here.

All fields with an asterisk (*) are required fields and must be filled in.

Adults

Children & Young people

Holiday crash courses

Holidy camps