TILMELDINGSFORMULAR * ENROLMENT FORM * FICHE D'INSCRIPTION
 
SPROGKURSUS
LANGUAGE COURSE
COURS DE LANGUES
 

 

Tilmeldingsformular - Enrolment Form - Fiche d'inscription EXIS

Please fill out in Danish or English.

 

Date:
First name:
Last name:
Address:
Country:
Telephone:
Mobile:
E-mail:
Nationality:
Occupation:
Education:
Birth date:
   
Do you smoke? yes
  no
   
Course:  
Course type:
Course town:
No. of lessons pr. week:
   
Lodging: kollegium/college
  lejlighed/apartment
  på skolen/at school
  privat indkvartering/private lodging
  dobbeltværelse/double room
  enkeltværelse/single room
   
Board: helpension/full board
  morgenmad/breakfast
  halvpension/half board
  ingen pension/no board
   
   
How long have you studied the languague you are signing up for? years months hours per week
   
Arrival date:
   
No. of weeks: weeks
   
Who to contact in case of illness, emergency, etc.
   
First name, last name
   
Address
   
Telephone
   
E-mail:
   
Eventuelle bemærkninger:
Comments:
   
How did you find Exis?
   
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