Courses & Membership Enrolment Form - For Adults

Method of Application

Step 1: Fill in the form below
Step 2: Print out the filled in form
Step 3: Sign the printed form
Step 4: Enclose Cheque
(Course + Membership Fee)
Cheque payable to: 'German Maltese Circle'
Step 5: Mail us the printed form and payment to:
'German Maltese Circle, Messina Palace, 141,
Triq San Kristofru, Valletta

Check with office for payment by instalment facilities. Booking to our Language Courses will only be confirmed upon payment!

All fields must be filled in.

First Name	Surname
Email	Sex
Date of Birth	Profession/Occupation
Address	Town Postcode
Mobile Phone Number	Fixed Line Number (Home/Office)
Identity Card Number	Nationality

Course Selected:

Have you ever been a member of the German-Maltese Circle?

Yes No

Do you want us to send you messages via SMS?

Yes No

Signature of Applicant

Signature of Parent or Guardian if under 18 years

By signing this form I confirm that I agree with the Language Courses Terms and Conditions / General Information and I undertake to abide by these conditions and regulations.

The German-Maltese Circle (GMC) hereby gives notice that the personal data provided and any other information supplied after the date hereof to the GMC, its employees, associates and collaborators will be recorded and processed as may be necessary by the said persons for the purpose of achieving the objectives of GMC. GMC hereby informs of the right of the data subject/parent/legal guardian to rectify or to erase personal data in this respect upon notification in writing and subject to the GMC's obligations under Maltese Law.

For Office Use Only

Date	Membership Number	Membership Receipt No.
Course Receipt Number	Course Fee Amount Paid (€)	Amount Due (€)