REGISTRATION FORM

INFO REQUEST:

 

Please complete this for our records to fill your registration certificate, useful to require the Visa. First Name : Last Name : Address 1 : Address 2*: City : ZIP Code: Country: E-mail : Place of Birth : Date of Birth : ---12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Gender: Female     Male Passport Number : Expiry date : ---12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Date of arrival in Italy : ---12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Date of Departure : ---12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Payment information: First Name : Last Name : Address 1 : Address 2*: City : ZIP Code: Country: E-mail : Western Union Ref Number: Date of Payment: ---12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember CONSENT OF TREATMENT OF PERSONAL DATA Note of the information provided about law 675/96 and in particular the rights granted by art. 13 of law 675/96, agree to the treatment, herein including the communication and dissemination of my own personal information, even of a sensitive nature, by the owner or delegated authority for the ends, and within the limits of, the nature of the above-mentioned information.

We are on the Embassy list of the Fashion Design Schools in Italy: www.ambwashingtondc.esteri.it Thank you for your cooperation in this matter.

 

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