ANMELDUNG / REGISTRATION LEARNING GERMAN IN MANILA

Fllen Sie dieses Formular bitte (mit schwarzem Stift) in DRUCKBUCHSTABEN aus. Please fill up this form in block letters with a black- inked pen.

General Terms and Conditions

1. General Requirements Course participants must be at least 18 years of age upon start of the class. Exception: Special requirements apply to participants of courses for children and teens. Terms of Payment 2.1 The course fee must be paid in full at the time of enrollment. 2.2 Enrollment is on a first-paid, first served basis. Reservations are not accepted. Course fees 3.1 The contractually binding fee is the fee stated in the price list current at the time of application. Should a participant wish to change his or her booking (change course schedule), then each booking change is subject to a fee equal to 10% the course fee. 3.2 Booking changes are only allowed up to one (1) week before the start of the course.

I would like to book the following course(s):

Start Deutsch 1 Course Package Super Intensive course Intensive course Extensive course
2.

Herr Mr.

Frau Ms.

(encircle one please)

Familienname (wie im Pass) Last name (as shown in passport) Vorname (wie im Pass) First name (as shown in passport) c/o (Representative) c/o Strae/nr. Street / no. PLZ/Ort Postal code / City Land Country Telefon (mit Vorwahl) Telephone (with area code) Handynummer (mit Vorwahl) Cellphone number (with area code) e-Mail E-mail Geburtsland Country of birth Geburtsort Place of birth Staatsangehorigkeit Citizenship Geburtsdatum Date of birth Muttersprache Native language Beruf Occupation

3. Course 1 Course dates Day/Time

Course 2 Course dates Day/Time

I am paying the course fee(s) in/via:

Cash Check (payable to Goethe-Institut Manila) Money transfer o LBC or 2Go door-to-door delivered to Arlene Gonzales (receiver) o Western Union or LBC to be picked-up by Policarpio Vicente, Jr. (receiver)

4. Cancellation and refunds The following conditions apply if the course participant is unable to take part in the course: 4.1 In case of cancellation up to one (1) week before the start of the course, Goethe-Institut Philippinen will withhold 50% of the course fee. 4.2 In case of late cancellation, non-appearance or leaving the course once it is underway, participants are not entitled to a refund. 4.3 Cancellations must be submitted in writing and must be accompanied by the original receipt. The date of cancellation shall be the date of receipt at the Goethe-Institut Philippinen office. 5. Course level assignment / class size 5.1 Placement in course levels is based on the placement test conducted at the Goethe-Institut Philippinen. 5.2 Our courses have at least 10 and at most 17 participants. If the number of enrollees are insufficient on the starting date, we reserve the right to cancel or postpone the course. In this case, we will offer the participants the opportunity to move to another course or to receive a full refund of the course fee. We regret that we can only conduct courses that have the minimum number of participants by the end of the enrolment period. To avoid cancellations of courses that would have taken place if the participants had enrolled in time, we advise students in their own interests to register in advance. 6. Responsibilities of participants Participants are obliged to comply with the course rules and house rules applicable to the Goethe-Institut Philippinen. 7. Liability of the Goethe-Institut The liability of Goethe-Institut Philippinen and its staff is limited to intent and gross negligence. Goethe-Institut Philippinen also accepts no liability for the cancellation of its services due to force majeur (e.g. natural disasters, fire, floods, war, official orders and all other circumstances beyond the control of the contractual parties). January 31 2012

Das Goethe-Institut weist darauf hin, das jeder Kursteilnehmer fr Schden aller Art, die er verursacht, selbst verantwortlich ist. The Goethe-Institut Philippinen hereby notifies the course participant that he/she is responsible for any damage of whatever nature that he/she causes. Die mir ausgehndigten Teilnahmebedingungen erkenne ich als verbindlich an. I hereby acknowledge as binding the General Terms and Conditions provided to me.

I have submitted the following requirements: A passport-sized picture Photocopy of passport or NBI clearance (please present original for verification)

______________________________________________________
Date/Signature Wenn ein Dritter die Kosten trgt, bitte eine entsprechende Erklrung beilegen. If a third party is covering the costs, please enclose a declaration to that effect.

Registration Procedure
Requirements: The course participant must be at least 18 years of age at the time of the start of the class. Exemption: Special requirements apply to participants of courses for children and teens under 18. Full payment of fees upon enrollment. Reservations not accepted. a passport-sized picture & photocopy of a current passport and/or NBI clearance (one each for a course and exam) Methods of payment: You may pay in Cash Check (paid to Goethe-Institut Manila) Money transfer o LBC or 2Go door-to-door delivered to Arlene Gonzales (receiver) o Western Union or LBC to be picked-up by Policarpio Vicente, Jr. (receiver) Important: In person You may visit our Language Course Office during its office hours (Mondays thru Fridays, 10:00 AM until 4:00 PM only) and ask for a Course or Exam Registration Form. Fill-up the forms completely, submit the requirements, pay the course fee (and purchase the course books - when applicable). You are officially registered only upon full payment of the course or examination fee. By fax or email You can also register by fax or email. Fill-up the registration forms (downloadable from our homepage) and send it together with proof of payment (copy of transaction receipt) via fax or email to: Goethe-Institut Philippinen Attention: the Registrar Fax no.: +63 2 8170979 Email: info@manila.goethe.org All payments are in Pesos only. Credit card payments or bank- to- bank deposits are unavailable at this time. All transaction costs are shouldered by the sender.

Confirmation of payment Please claim your receipt as proof of payment. For applications sent through money transfer, we confirm by text message or email. If you do not receive any confirmation within a week of sending your payment, please call our office to verify the status of your application.

For inquiries, please contact:

Goethe-Institut Philippinen G/4-5/F Adamson Center #121 L.P. Leviste St., Salcedo Village 1227 Makati City, Metro Manila Philippines Tel. +63 2 8405723 to 24 +63 2 8170978 to 79 Fax: +63 2 8170979 info@manila.goethe.org www.goethe.de/manila

General Terms and Conditions

1. General Requirements Course participants must be at least 18 years of age upon start of the class. Exception: Special requirements apply to participants in courses for children and teens. 2. Terms of Payment The course fee must be paid in full at the time of enrolment. Enrollment is on a first-paid, first served basis. Reservations not accepted. 3. Course fees 3.1 The contractually binding fee is the fee stated in the price list current at the time of application. Should a participant wish to change his or her booking (change course dates), then each booking change is subject to a fee equal to 10% the course fee. 3.2 Booking changes are only allowed up to one week before the start of the course.

5.

Course level assignment / class size 5.1 Placement in course levels is based on the placement test conducted at the Goethe-Institut Philippinen. 5.2 Our courses have at least 10 and at most 17 participants. If the number of enrollees are insufficient on the starting date, we reserve the right to cancel or postpone the course. In this case, we will offer the participants the opportunity to move to another course or to receive a full refund of the course fee. We regret that we can only conduct courses that have the minimum number of participants by the end of the enrolment period. To avoid cancellations of courses that would have taken place if the participants had enrolled in time, we advise students in their own interests to register in advance. Responsibilities of participants Participants are obliged to comply with the course rules and house rules applicable to the Goethe-Institut Philippinen. Liability of the Goethe-Institut The liability of Goethe-Institut Philippinen and its staff is limited to intent and gross negligence. Goethe-Institut Philippinen also accepts no liability for the cancellation of its services due to force majeur (e.g.natural disasters, fire, floods, war, official orders and all other circumstances beyond the control of the contractual parties).

Declaration of Consent:
I hereby authorize the Goethe-Institut Philippinen to communicate my Start Deutsch 1 exam results to the German Embassy in Manila for visa purposes. I certify that I have read and understood the examination guidelines. I understand that I will be charged the full test fee if I cancel or postpone my test. I certify that the information on this form is complete, true and accurate. I understand that if any other person attempts to take the examination in my place, both I and such person are liable to prosecution. I understand that I am required to present my passport as proof of identification on the exam day and when I claim my test results/certificate. I understand that I will not be allowed to take the exam if I am late. I understand that I am allowed to bring only a blackinked pen in the exam room. I understand my results will be available at least one (1) week after the test day. I understand that the test results will be released only to the examinee. I understand that the work I produce as part of the examination remains the property of the testing center and under no circumstances will be released to candidates or institutions/organizations. I understand that if I fail the exam, I may view my test paper (upon a request in writing) only in the presence of the Exam Coordinator. I understand that if the details on this form are not completed, my application may not be processed.

6.

4. Cancellation and refunds The following conditions apply if the course participant is unable to take part in the course: 4.1 In case of cancellation up to one (1) week before the start of the course, Goethe-Institut Philippinen will withhold 50% of the course fee. 4.2 In case of late cancellation, non-appearance or leaving the course once it is underway, participants are not entitled to a refund. 4.3 Cancellations must be submitted in writing and must be accompanied by the original receipt. The date of cancellation shall be the date of receipt at the Goethe-Institut Philippinen office.

7.

Das Goethe-Institut weist darauf hin, das jeder Kursteilnehmer fr Schden aller Art, die er verursacht, selbst verantwortlich ist. The Goethe-Institut Philippinen hereby notifies the course participant that he/she is responsible for any damage of whatever nature that he/she causes. Die mir ausgehndigten Teilnahmebedingungen erkenne ich als verbindlich an. I hereby acknowledge as binding the General Terms and Conditions provided to me.

______________________________________________________
Date/Signature Wenn ein Dritter die Kosten trgt, bitte eine entsprechende Erklrung beilegen. If a third party is covering the costs, please enclose a declaration to that effect.

______________________________________________________
Date/Signature

(Students/examinees copy) Janaury 31,2012