without e-mail
address are
not accepted
by the system.
Please complete
all details.
1. Given and family names
2. E-mail
3. Phone number
4. Gender Male Female
5. Birth date
6. City of the student
7.What is your mother tongue?
8.Other languages
9.How much Dutch do you know?
10.When would you like to start?
11.How long would you like to join?
Which days of the week
do you prefer to have lesson?
SaturdayWeekdays evening
Sunday Weekdays daytime
Other days and time (please fill in at "Other questions/remarks")
13.In groups or private? Groups lesson preferred   Private lessons preferred
Other questions/remarks