Contact details of contact person Family name:* First name:* Street and house number:* Postal code:* City:* Country:* Email address:* Repeat email address:* Phone number:* Fax number: I have the participant's permission to act as his/her contact person and communicate with Sprachenakademie Aachen on his/her behalf.* Please scan the passport of the participant (incl. visa/residence permit, if applicable) and upload the scan here. * Please use file formats JPG, PNG or PDF. The limit is 5MB. Contact details of the participant Family name:* First name:* Date of birth:* City of birth:* Country of birth:* Street and house number:* Postal code:* City:* Country:* Email address:* Repeat email address:* Phone number:* Fax number: About the booking Course number (please only list the modules that you wish to cancel): Start date of the earliest module you wish to cancel:* Did you also book an accommodation through Sprachenakademie Aachen? ———yesno Please note that in case you booked an accommodation together with you German course, the accommodatin, too, will be cancelled in case of a cancellation of the course. The cancellation deadline for accommodation bookings ends 28 days prior to the beginning of the rental period. If the deadline is met, the rent paid in advanced is refundable. A processing fee will be deducted. Please state the reason why the participant is unable to join the course.* ———The visa application of the participant has been rejected.Other reason Please upload a scan of the rejection letter. * Please use file formats JPG, PNG or PDF. Please specify the reason.* Would you like to book a different course instead? ———yesno Please indicate the title, course number and start date of the course you wish to book. Bank details Please enter the bank details of the account that any refundable fees should be transferred to. Information on the account holder Account holder:* Street and house number:* Postal code:* City:* Country:* Information on the bank IBAN: Account number: * BIC/SWIFT:* Name of the bank:* Street and house number:* Postal code:* City:* Country:* I acknowledge that by submitting this form, I agree to abandon the claim of the participant to a place in the course in question.* The personal data provided in this form, especially your name, address and date of birth, are being collected solely for the purpose of handling your request. They will be processed by Sprachenakademie Aachen gGmbH in accordance with the data protection regulations. Detailed information on data protection as well as on your right of revocation can be found here. I agree that my personal data and the personal data of the participant may be stored and processed for the purpose of handling my request.* * = Obligatory field 24998