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“Meet a coordinator”

 

Send this form to EUROSPEAK Brussels, Ghent or Antwerp and we will contact you as soon as possible.

Your personal information will only be used to process your request. We are committed to ensuring the privacy of all the information we collect.

Some questions have multiple options. Fields indicated with an asterisk (*) are required to complete this questionnaire.

 
Coordinates
 
Name*
First name*
Function
Name company / school
Street
Number
Box
Postal code
City
Email*
Telephone (home)*
Telephone (office)
Fax
Mobile
 
Request
 
Language you want to learn:
And, if possible, also
Number of participants
Current level:
  Absolute beginner
  Elemantary            
  Intermediate            
  Advanced            
When would you like the course to start?
 
I'm interested in:
  a tailor-made course
  an intensive course
  a functional module
  a open group course
  language by telephone
  language counselling
  e-learning
  a course for children or students
  a language project for a specific organisation
  a school project
a course for expats
Other, please specify
 
Eurospeak
 
Have you already taken classes at Eurospeak?
  yes            
  no            
 
Message
 
Message (this might include your specific needs, goals, any remark,...) or question
 
Contact
 
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