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+ 49 89 15921200
Please fill in this form in black ink and CAPITAL LETTERS and return it to Munich.
Kundenmanagement Telefax: + 49 89 15921202
Goethestr. 20 E-mail: deutsch@goethe.de
80336 Mnchen goethe.de/germany
Germany
male female
Last name (as shown in passport) First name (as shown in passport)
Date of birth day month year Last name (as shown in passport)
Citizenship E-mail
Country
20 20
day month year day month year
IN ADDITION TO THE COURSE I AM BOOKING THE FOLLOWING ACCOMMODATION (SEE AVAILABLE CHOICES IN THE COURSE CALENDAR)
Guesthouse Single room Smoker Breakfast (only available in Dresden, Schwbisch Hall)
Homestay Double room Non-smoker Lunch (only available in Schwbisch Hall)
Apartment
The Goethe-Institut hereby notifies the course participant that he is responsible Received from (institute stamp)
for any damage of whatever nature that he causes.
Institute code
If a third party is covering the costs, please enclose a declaration to that effect. Agency code
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EN SELF-ASSESSMENT OF GERMAN SKILLS
To ensure that we can enroll you in a suitable course for you, we request that you answer all of the following questions:
Wenn Sie an einem Goethe-Institut im In- oder Ausland Deutsch lernen oder gelernt haben, werden Ihnen
unsere dortigen Kolleginnen und Kollegen gern eine Einstufungsempfehlung geben:
Frau/Herr
A1 A2 B1 B2 C1 C2
SEND
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EN TERMS AND CONDITIONS
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EN NOTICE OF RIGHT TO CANCEL AND CANCELLATION FORM
Consumers have a right to cancel in accordance with the following conditions. For
this purpose, a consumer is defined as any natural person entering into a transaction
for purposes not primarily related to commercial or self-employed activities:
Right to cancel If you wish to cancel the contract, please complete this form and return it to us.
You have the right to cancel this contract within 14 days without giving reasons. The
cancellation period is 14 days from the date on which you enter into the contract.
To
Goethe-Institut e.V.
To exercise your right to cancel, you must send a clear declaration to us at:
Goethe-Institute in Deutschland
Goethe-Institut e.V.,
Bereich Marketing und Vertrieb
Goethe-Institute in Deutschland,
Goethestrasse 20
Bereich Marketing und Vertrieb,
80336 Munich
Goethestrasse 20,
Fax: +49 (0)89 15921 202
80336 Munich,
E-mail: deutsch@goethe.de
Tel.: +49 89 15921-0,
Fax: +49 (0)89 15921-202,
I/we (*) hereby cancel the contract entered into by me/us (*) on the purchase of the
E-mail: deutsch@goethe.de following goods (*)/ the performance of the following service (*)
(e.g. a letter, fax or e-mail) indicating your decision to cancel this contract. The
attached Sample cancellation form (PDF, 95 KB) may be used to notify us of your Ordered on (*)
decision to cancel, but it is not required.
To comply with the cancellation period, it is sufficient for you to send your notice of received on (*)
cancellation to us before the cancellation period expires.
Name of consumer(s)
Consequences of cancellation
If you cancel this contract, we are required to reimburse all payments that we have
Address of consumer(s)
received to you, including delivery costs (with the exception of additional costs
resulting from your selection of a delivery option other than the cheapest standard
delivery option offered by us) without delay and no later than 14 days from the
date on which we receive notification of your cancellation of this contract. For the
reimbursement we use the same means of payment as in the original transaction
unless we have expressly agreed to other arrangements with you. You will not be
charged fees for this reimbursement under any circumstances.
If the delivery of services begins at your request during the cancellation period,
you are required to pay us an appropriate amount corresponding to the portion of Date
the services provided during the cancellation period as a percentage of the total
contractually agreed services.
End of notice of right to cancel Signature of consumer(s) (only in case of notification on paper)
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