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Get ready for your best language learning experience!
Fill out the following form in order to register for a course.
If you need assistance, do not hesitate to call us at 866-72-CERAN.

Personal details

Gender:* Ms Mrs Mr
First name: *
Last name: *
Address 1: *
Address 2:
City/Town: *
State/Province: *
zip: *
Country: *
Please specify:
Date of birth (mm/dd/yyyy): *
Nationality:
Phone number: *
Fax:
Mobile:
E-mail: *
Mother tongue:
Preferred contact language: *
Function: *
Please specify:
I heard about CERAN LINGUA from: *
Please specify:

Company details

Are you with a company : * Yes No
Company name: *
Group name:
Sector: *
Please specify:
Person responsible for language training: *
Address 1: *
Address 2:
City/Town: *
State/Province:
zip: *
Country: *
Please specify:
Direct phone number: *
Company phone number: *
Fax:
E-mail: *

Your program

Language: *
Center: *
Dates (mm/dd/yyyy): *

Week starting on

to

Note: our programs start on Sunday evening and last until Friday afternoon.
Program: *
Chosen areas of specialization (1 or 2 maximum per week)
Diplomacy/Institutions
Banking/Finance
Legal
Logistics
Economic development and Agronomy		 Marketing/Sales
Human Resources
New technologies
Pharmacy/Cosmetics
Communicative situations (1 or 2 maximum per week)
Participating in or chairing a meeting
Giving presentations
Negotiating (buying, sales, diplomacy,..) 		Providing technical assistance
Drawing up reports or mail, ...

Options

Saturday Morning Private Lessons
 
No private lessons
2 private lessons
4 private lessons
Accommodation *
 
Standard
Standard
Full board and single room accommodation with shower/bath and WC are included in the price of your program. If you prefer accommodation at a higher standard, please indicate it above.
Extra nights at weekends
 

Number of additional nights at the weekend :
(Breakfast included)

Nights from Friday to Saturday:
Nights from Saturday to Sunday:
Transfers
 
on arrival on departure
(None)
Brussels Zaventem Airport
Brussels South (Midi) Station
Brussels South (Charleroi) Airport
Liège Guillemins Station
Verviers Station
on arrival on departure
(None)
Madrid Barajas Airports
on arrival on departure
(None)
Avignon Airport
Marseille Airport
on arrival on departure
(None)
Birmingham Airport
London Heathrow Airport
Central London
CERAN Course Packs
 
CERAN Course Pack for beginners
level(s) of the CERAN course to prepare for your stay
level(s) of the CERAN course to follow on from your stay
Distance language coaching packages
 
Language Diagnosis
 
( Please tick only if you are not registering for a seminar )

Your level

Your existing knowledge of the target language determines the module for your program.
Self-evaluation: select the box corresponding to your level
Beginner
Elementary
Intermediate
Advanced

Miscellaneous information

Please send the reservation, pratical information, map and CERAN course pack to: * my private address*
my company address*
my company, for the attention of: *
Ms Mrs Mr
Job title:

Name:

First name:

E-mail:
Please send the invoice to: * my private address*
my company address*
my company, for the attention of: *
Ms Mrs Mr
Job title:

Name:

First name:

Email:
Please send an additional copy of the end-of-stay Linguistic Skills Assessment to: * my private address
my company address
my company, for the attention of:
Ms Mrs Mr
Job title:

Name:

First name:

Email:

Payment methods on receipt of invoice

Method: *
Please send us your credit card details as soon as you receive the invoice.
I hereby acknowledge and accept the sales terms and conditions *
Comments:
Date: * 04 July 2009