1. Program choice:
One-year course: 1st semester 2nd semester
OR
Summer School: July 7 July 28
Duration: Intensity:

2. Type of accommodation:
university dormitory
other (organised by the participant)

3. Personal data:

Family name:

First name:

Date of birth: - -

Place of birth:

Sex: Male Female

Father`s (first) name:

Mother`s (first) name:

Citizenship:

Passport No.:

Address (COUNTRY/ CITY/ POSTAL CODE/ STREET/ HOUSE NUMBER):

Email address:

Phone number:

Occupation:

4. What is your motivation to participate in the course in Poland?

5. Have you done any previous courses in Polish? If so, give details (e.g. previous NAWA courses)

6. Rate your knowledge of the Polish language:

speaking: none poor fair good

reading: none poor fair good

writing: none poor fair good

7. Other foreign languages:

8. Important health/allergy information you wish to communicate to the school administration office

9. Preferred diet:
regular (with meat)
vegetarian
vegan

10. I declare that I will possess a valid health insurance for the period of my stay during the course and I take full responsibility If I will not meet this requirement
I consent

11. Name and telephone number of a person to be notified in case of emergency:

12. For transfer of credits, supply complete address of your school`s Registrar:

13. Consent for data processing: (PDF)
I agree

14. Declaration of consent to the processing of personal data in the form of photographs, video and audio: (PDF)
I agree

15. Regulations:

One-year Polish language course: (PDF)
Summer School: (PDF)

I accept the regulations