APPLICATION FORM
		SLOVAK LANGUAGE IN SLOVAKIA
Apply early before deadline.
Last day for Application: 11 July, 2005
First Name					Last name
Date of Birth					Sex                          ٱ  Male             ٱ   Female
Address				City			Country
Phone  (         ) (         )			Fax  (         ) (         )			e-mail
Country     city			Country   city
Passport No				Nationality			Occupation
What is your current level of Slovak ?
ٱ  Total Beginner             ٱ   Elementary             ٱ  Low Intermediate            ٱ  High Intermediate
Knowledge of other language
Accommodation
ٱ   Yes                                                 ٱ   No
ٱ Type A           ٱ  Type B
Are there other important facts we need to know
Person to contact in case of emergency
Name			Address			City		Country
Phone  (         ) (         )			Fax  (         ) (         )			e-mail
Country   city			Country  city
I agree that:
1) The above information is true
2) Application form will not be proceeded without giving a copy of the identification
page of the passport (page with photo and personal details)
	Date					Signature of Student
Return to:
	e-mail:sabovaludka@hotmail.com
	Fax:+ 421 51 77 24 124