Application Request Direct Simple Purchase

Application Request: Short Fashion Business Plan

Welcome to the two-step application process for Polimoda.

You’re about to embark on a straightforward journey to secure your place in your selected course.
This application process involves two steps:

filling out your personal data sheet
paying the tuition fee.

Please carefully read the application guidelines associated with the course to ensure a successful submission.

Payment options
For your convenience, we offer multiple ways to pay the course fee.
You can make a direct online purchase using a credit card or PayPal, or opt for a bank transfer.

Information

Personal details

First Name*

Last Name*

Email*

Gender*

Date of Birth*

Attention!

The application request for underage students must be completed by the parents/guardians in the name and on behalf of the minor.
The parents/guardians must fill in the fields dedicated to them in this registration.

City of Birth*

State or Province of Birth*

Country of Birth*

Citizenship*

Social Security Number (SSN)

ID card or Passport*

Drag your file or click here to upload. Max size: 12MB Formats: jpeg, jpg, png, pdf

Residence

Address*

Postal code*

City*

State or Province*

Country*

Address in Italy

Address

Postal code

City

Contacts

Mobile number*

Home number

Skype

Parents/guardians

First parent/guardian

Who you are?*

Personal details

First Name*

Last Name*

Email*

Gender*

Date of Birth*

City of Birth*

State or Province of Birth*

Country of Birth*

Citizenship*

Social Security Number (SSN)

ID card or Passport*

Drag your file or click here to upload. Max size: 12MB Formats: jpeg, jpg, png, pdf

Residence

Address*

Postal code*

City*

State or Province*

Country*

Contacts

Mobile number*

Home number

Skype

Other parent

No other parent

Personal details

First Name*

Last Name*

Email*

Gender*

Date of Birth*

City of Birth*

State or Province of Birth*

Country of Birth*

Citizenship*

Social Security Number (SSN)

ID card or Passport*

Drag your file or click here to upload. Max size: 12MB Formats: jpeg, jpg, png, pdf

Residence

Address*

Postal code*

City*

State or Province*

Country*

Contacts

Mobile number

Home number

Skype

Application

Course*

Year*

Edition*

Academic Qualifications

Completed Qualification*

Year*

Institute*

City

Language skills

English level*

Other

How did you hear about this course?*

Payment preferences

Which payment method will you use?*
Bank TransferCredit Card

Confirm

Contract Agreement

The user declares to have read, understood and accepted the contractual conditions and confirms his/her intention to proceed with the enrolment process. Consent and all personal data shall be processed fairly and lawfully unless the user is restricted by applicable law. Therefore the user:*

The undersigned parent/guardian
declares to have read, understood and accepted the contractual conditions and confirms his/her intention to proceed with the enrolment process. Consent and all personal data shall be processed fairly and lawfully unless the user is restricted by applicable law. Therefore the user:*

YesNo

European General Data Protection Regulation (EU) 2016/679

Noting that my data will be processed in full compliance with the law, I declare, by submitting the present form, that I have read and understood the Student Privacy Policy.*

The undersigned parent/guardian
declares to have read and understood the information provided by the Data Controller pursuant to art. 13 of GDPR No. 679/2016 regarding the management of personal data, and authorises Polimoda to process the minor’s personal data for all purposes related to the execution of the contract*

YesNo
(*data processing that is necessary for the execution of the agreement)

I consent to the processing of my personal information for promotional purposes, relevant news and information about programs, events, initiative also in support of Polimoda¹

authorises Polimoda to process the minor’s personal data in relation to Polimoda’s communication activities, also for promotional purposes, as well as the dissemination of informative material related to programmes, events, initiatives organised by Polimoda and/or its partners¹

YesNo
¹ You may unsubscribe at any time

Payment

Bank Transfer

We will contact you to communicate the payment details for the bank transfer.

Credit Card

You will be able to make the payment on the next page.