Enrol 1252 036 en

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Enrol 1252 036 en

  1. 1. ETUI EDUCATION ENROLMENT FORM PLEASE TYPE OR WRITE CLEARLYTo all organisations affiliated to the ETUC ONLINE ENGLISH LANGUAGE LEARNING PROGRAMME FOR EUROPEAN TRADE UNIONISTS - ELEMENTARY TO UPPER-INTERMEDIATE LEVEL 1st May 2012 – 31st October 2012 Course reference: 1252-036Name of contact person:Organisation (in your own language) and in abbreviation:Address (work):Billing address (invoice for inscription fee):Affiliation: please indicate the Confederation or European Industry Federation to whichyour organisation is affiliatedTelephone: (work) Fax:E-mail:Organisation’s web site:Participation fee FOR SIX MONTHSWestern Europe: 150€ /personCEEC (Central and Eastern Europe) : 75€/personPayment of registration:An invoice will be sent to the organisation upon reception of the enrolment.Log in instructions will only be sent once we have received payment.It is essential that you mention in your payment order the number of theinvoice and customer reference number.Date SignatureETUI aisbl is financially supported by the European Union

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