Pick up Application Form

PERSONAL DETAILS

(*) MANDATORY FIELDS

Family name(*)

Last name is required.

Given Name(*)

First name is required.

Gender(*)

Please choose an option.

Document Type(*)

Document Number(*)

Date of birth(*)

Mobile phone number(*)

Please fill your mobile phone number.

Telephone(*)

Telephone is required.

Email(*)

Email is required.

Confirm Email(*)

Please confirm your email.

Given e-mail address must be unique.
THERE CANNOT BE 2 people with the same email address. No error will be shown but filled out data will not be saved.
Make sure you specify an email address that you read on a regular basis and do not forget to check your SPAM folder.

Nationality(*)

Nacionality is required.

Reason for your stay at the UA

Please enter details of who to contact in the event of an emergency

Name

Telephone Number

PICK UP SERVICE

Date of arrival(*)

Time of arrival(*)

Place of arrival(*)

Flight/Train number(*)

Destination Address(*)

Price

PAYMENT METHOD

Credit or Debit Card (Online payment through the bank's payment gateway) *American Express not accepted

IMPORTANT: To use this payment method it is necessary to:

Enter your card details in the payment gateway.
Have an additional security code (the bank will send it by SMS or via the mobile phone application).
Some banks ask for a key to the coordinates card to operate online.

It is essential to have your phone or coordinates card to hand in order to be able to make the payment.
Please, in the payment gateway, always click on the continue button, whether the payment has been successful or not.
Please consult the first Frequently Asked Questions (FAQ).

Bank Trasfer

Account Holder: Centro Superior de Idiomas de la Universidad de Alicante, S.A.U.
Bank: Banco Santander
Swift Code: BSCHESMMXXX
IBAN Code: ES46 0049 6659 0328 1613 4203
Concept: “PICK UP + Surname(s), Name (of student)”

Important:

When making the bank transfer or payment, ensure that the following appears: “PICK UP + Surname(s), Name (of student)”
Ensure that bank charges are met by the payer.
Please check that the amount transferred, after bank charges have been paid, corresponds to the accommodation fee.
This application form will not be effective until the proof of payment is attached to this form.

I have read and accepted the conditions relating to the General Data Protection Regulations

You must accept the conditions of the General Data Protection Regulation.

To verify that you are not a robot, please type the answer to the following addition problem:

19 + 18 =