MASTERCLASS ACADEMY OF LANGUAGES B.V. REGISTRATION General Information First Name* Last Name* Date of Birth* Gender* MaleFemale Street* Post Code* City* Email* Phone* Course Selection Level* Course name Day/ Class time Tuition fee Total tuition fee €0.00 Payment Information I wish to pay by: iDEALInternet bankingInvoice Signed: Date: Masterclass Academy of Languages B.V. Botersloot 9C, 3011 HE Rotterdam Tel: 0107532037 info@masterclassdutch.com www.masterclassdutch.com