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Booking Form - Step 1 of 2

  • Please fill out all necessary fields carefully and truthfully.
  • The first three sections "personal data", "school" and "accommodation" must be filled out.
  • When you click 'send' at the end of this page, you will receive a confirmation e-mail within 15 minutes. If you do not get a confirmation within this time, you should contact us by e-mail to the following address:
  • Javascript should be activated, else this form cannot be processed correctly.
 Personal data
 
  Salutation:
 Mr.    Ms./Mrs.  
 
  First name:  
  Surname:    
  Address:  
  Postal code:  
  City:  
  Country:
       
  Telephone (p):  
  Telephone (o):
[optional - Office"]
  Telephone (m):
[optional - Mobile"]
  Fax:
[optional"]
  E-Mail:
[VERY IMPORTANT"]
       
  Birthday:  
(dd.mm.yyyy)
 e.g. 27.05.1978
  Occupation:
[optional"]
       

 Language course
     
  Language level:
good knowledge   
average knowledge
fundamental knowledge
none
       
  Starting date:
(dd.mm.yyyy)
 Courses in minigroup start on Mondays!
  Duration: week(s)  
       
  Course:
 
  Minigroupe  
    
Standard 
Intensive
Crashcourse
Spanish for Specific Purposes (SSP)
       

 Accommodation
       
  Accommodation:
no accommodation  
Hostfamily, HB approx. 120$/W
Hostfamily, FB approx. 130$/W
Hostal, SR, B approx. 100$/W
Hostal, DR, B approx. 140$/W
Hotel La Casa Sol starting from 100$/W
Hotel Plaza Int. starting from 100$/W
Hotel Quito, SR, B approx. 365$/W
Cafe Cultura, SR, B approx. 395$/W
Cafe Cultura, SR, B approx..480$/W
       
  from:
(dd.mm.yyyy)
  to:
(dd.mm.yyyy)
        
  Auxiliary information: : Smoker
Additional personal information, e.g. allergies, health problems etc. can be communicated later by telephone or fax.
    Vegetarian
   
 

SR = single room, DR = double room,
B = with breakfast, HB = half-board, FB = full-board
       

 Leisure offers
       
  If the Academia Bipo & Toni's offers any trips or courses, I would be interested in the following:
       
  Trips: Jungle
~ USD 585,40 per week
    Costa / Baños
~ USD 250,00 per week
    Otavalo
~ USD 250,00 per week
       
  Courses: Dance course
USD 5,00 per hour
    Cook course
USD 6,00 per hour
    Guitar course
USD 6,00 per hour
       

 Flight/arrival
       
  Airline: e.g. Iberia
  Flight No.: e.g. IB7367
  Arrival date:
(dd.mm.yyyy)
  
  Arrival time:
(hh:mm)
 
       

  Final remarks
   
  Do you travel in a group?
  If YES, please enter the name or if available the booking number of the responsible person:
   
  Discounts:
 
I am booking online and therefore I benefit from
original prices, i.e. no additional agency fees.
   
Additionally (to the original prices), I benefit from a discount of 5%,
because I am booking more than 120 lessons.
   
Additionally (to the original prices), I benefit from a discount of 5%,
because I am booking at least 120 days in advance.
   
  I know "Bipo & Toni's" from:  
   
  Remarks / wishes:
 
[max. 1000 characters"]
   
 
I agree with the fact that this form is conveyed like a normal E-Mail message without additional encryption, since it does not contain personal data, which would be subject to data security.
 
 
 

 
 
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Ortszeit, Quito
 
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Vielen Dank. Ihre freundliche Spanisch Sprachschule im südamerikanischen Quito, Ecuador.
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