PERSONAL
INFORMATION
Mrs
Mr
*First
Name :
*Last
Name:
*Birthday
*Motherlanguage
*Address:
*ZIP:
*City:
*E-mail:
*Telephone:
*Job/Occupation:
*How
did you hear from us?
PROGRAM
please choose
Intensive month € 250,-
Intensive 2 weeks with accomodation
Intensive 4 weeks with accomodation
Intens. 2 weeks, accomodation, extra individual classes, leisure
programme
Intens. 3 weeks, accomodation, extra individual classes, leisure
programme
Intens. 4 weeks, accomodation, extra individual classes, leisure
programme
Starting
date:
How
long do you plan to study at Deutsch Akademie ?
weeks
At
what time would you prefer your course? (We will try to take your
choice into consideration)
9-12h
12-15h
15-18h
18-21h
YOUR
LEVEL
When
you have completed the form we will send you a test to evaluate your
level.
How
many course hours did you already have?
Stunden
Which
course material did you use before?
Tangram
1A
Tangram
1B
Tangram
2A
Tangram
2B
Moment
mal 1
Moment
mal 2
Moment
mal 3
Sprachkurs
1
Sprachkurs
2
Sprachkurs
3
Themen
1
Themen
2
Themen
3
EM
andere
andere:
How
would you describe your level?
Please
choose...
absolute beginner level
beginner level
Ich
kann einfache Sätze bilden...
Ich
kann mich etwas auf Deutsch unterhalten aber mache viele Fehler. Mein
Wortschatz ist gering
Ich
kann mit einigen Fehlern alles sagen, was ich möchte und verstehe
fast alles.
Ich
spreche fließend Deutsch. Nur noch einige Feinheiten beherrsche
ich nicht ganz...
Ich
spreche fast fließend aber mache viele Grammatikfehler
ACCOMMODATION
Yes
No
No
Residence
Double bedroom in a student residence
Single bedroom
Host
family
No
host family
Yes:
Host family (double bedroom) with breakfast
Host family (double bedroom) halfboard
Diat/allergies?
If YES, pleasegive details
Smoker
Yes
No
Special
wishes or remarks:
Appartment
(studio)
No Appartment
studio
Special
wishes or remarks:
TRANSFER
Transfer on arrival
no Transfer
Arrival
day :
Arrival
time :
AM
PM
Arrival
place
(airport or station):
Flight
or train no:
Transfer
on depature
No
Depature
day :
Depature
time :
AM
PM
Flight
or train no:
SEND
YOUR MESSAGE
By
sending this message, I hereby agree that I have read and agree to
comply with the Terms and Conditions of Deutsch Akademie .
We
will reserve you a place as soon we have evaluated your german level
and as soon you have paid the whole course fees.