Course Application Form 20151
Course Application Form 20151
Personal details:
1. Full Name (Surname, First name): ____________________________________________________________________________
2. Age:
below 18
18 25 years
26 35 years above 35 years
3. Sex:
male
female
4. Date of Birth:
____________________________ Place of Birth:_______________________________________________
5. Nationality:
____________________________ Mother tongue: ___________________________________________
6. Address:
____________________________________________________________________________________________
___________________________________ Pin Code, City: ____ ___________________________________
7. Telephone No.:
___________________________________ Mobile: _______________________________________________
8. Email:
___________________________________________________________________________________________
9. Occupation:
school student
student (undergraduate/postgraduate) research/academics
service/professional business/self-employed
home-maker
retired/not currently employed
others (specify) _______________________
students or home-makers):
Natural Sciences
Biological Sciences/Medicine
Literature/Languages
Fine Arts/Performing Arts
Media/Communication Public Administration/Civil Service
Law
Others (specify) ________________
11. Why do you wish to learn German? (You can mark more than one option)
I need it for my current field of study/work
I intend to study/work in a German-speaking country (Germany, Austria, Switzerland, Liechtenstein)
I feel it will help me in my career/future
My spouse/partner/fianc/fiance lives in Germany and I wish to join him/her there
I have family members living in a German-speaking country
I like learning languages
Others (mention): ___________________________________________________________________________________
12. Do you have previous knowledge of German? Yes No
If yes, where did you learn it? _________________________________________________________________________
How long and up to which level did you learn it? _____________________________________________________
13. How did you come to know about our language course? (You can mark more than one option)
From posters/flyers (if so, then mention where you saw the poster/flyer) ________________________
From news articles (If so, then mention the source)_________________________________________________
From the internet (If so, then mention the website)_________________________________________________
From friends/family members________________________________________________________________________
Recommended by another institution/organisation (if so, name it)_________________________________
___________________________________________________________________________________________________________
___________________________________
(Signature of applicant)
THANK YOU FOR YOUR TIME
To be filled up by the course enrolment officer
Course
____________________________________
Course Fee
____________________________________
Duration _________________________________________________
Amount paid ____________________________________________