Booking Form Summer School in Audiovisual Translation 4 – 29 July 2016 Personal details Title (Mr, Mrs, Ms, Miss) Surname First Name Address for correspondence E-mail address Telephone (home) Telephone (mobile) Date of birth Country of birth Registration (deadline 6th May) Module A: Dubbing and Voice-over Yes No Module B: Subtitling Yes No Module C: Accessibility to the Media Yes No Fee for entire course (all modules): £650; Fee for individual modules: £230 Background Language combination (refer to languages offered) Professional translator Yes No Student of translation Yes No If student, undergraduate Yes No If student, postgraduate Yes No Statement. Tell us why you would you like to enrol on this course. Once completed, please return by email, with a copy of your CV, to Dr Soledad Zarate: soledad.zarate@ucl.ac.uk You will be shortly notified if you have been accepted onto the course. If you have been successful, you will also receive more detailed information on how to pay your fees. We look forward to welcoming you at UCL.