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Application form
 

COURSE TYPE:


A. PERSONAL DETAILS.

Mr/Mrs/Miss

( Family Name *) ( First Name *)

Address for corespondence*:


tel/fax*
e-mail*

Nationality*: Native Language*:

Date and place of Birth: Occupation:

B. COURSE DETAILS.
starting on: finishing on:

Your special interests:


Your knowledge of Polish (please rate your ability in Polish to:)

listen and speak:
Excellent Very good Good Poor

read and write:
Excellent Very good Good Poor

communicate:
Excellent Very good Good Poor

How long have you been learning Polish and where?

Why do you wish to learn Polish?

How did you hear about our Centre?
internet
friend
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C. ACCOMMODATION ( if required ).

If accommodation were arranged, I would prefer to stay:
in a student dormitory (only July & August):
      12 - 14 Euro per day,
with Polish family: 13 - 15 Euro per day, room & breakfast,
in a holiday house: 35 - 50 Euro per day, meals incl.,
in a hotel: from 35 Euro per day, B & B.

Can you stay in a home with pets (dog/cat)
Yes No

Do you have any special dietary reqiurements:


Any other information you would like us to know when finding you an accommodation:

D. DEPOSIT.

I send with this Application Form / have paid by Bank Transfer the nonrefundable deposit of 500 PLN (Intensive Group or Individual Courses -"everyday" lessons).

E. A LETTER OF ACCEPTANCE.

If you need A Letter of Acceptance we require payment of a one-week tuition fees.

Any other information you would like us to know:

F: GENERAL CONDITIONS.

I accept General Conditions Yes No



Write code: 

* Please complete the Application Form and send it to the school with your payment or copy of the Bank Transfer Document.


WELCOME TO THE CENTRE FOR POLISH LANGUAGE STUDIES
 

 

 

* Learn Polish  *   Ucz się polskiego * Polish Courses *

* This offer is for information purposes. This offer does not constitute an offer within the meaning of art. 66 § 1 of the Civil Code and other relevant legislation.