APPLICATION FORM
Danish Summer Language Course in Copenhagen, Denmark
4 to 22 July, 2016
NAME AND ADDRESS
First and middle names (all names are required):Family name (as stated in your passport):
Nationality:
Permanent address:
Mailing address (if different from above):
Phone: / Mobile phone:
Email: / Member of Danes Worldwide
Yes
No
Date of birth (dd-mm-yyyy) / Sex
Female
Male
Language information
How well do you speak, understand and read Danish?I am completely beginner (1)
I can understand something and say some phrases (2)
I can make a simple conversation in Danish (3)
I can read newspapers and books and discuss in Danish (4)
I can read, talk and write in Danish but need more practice (5)
Other foreign language(s) spoken:
Payment
Payment should be made to:
S.W.I.F.T. address: DABADKKK
Bank: Danske Bank
Bank address: Holbergsgade 2, DK-1057 København K
Registration No.: 4180
Account No.: 3004899
IBAN: DK46 3000 0003 0048 99
Kindly specify name and project No. 16 10 003
When payment has been received, you will be officially enrolled in the course.
We will inform you by mail.
Price for members of Danes Worldwide: DKK 6000. For non members: DKK 7000
Transport for cultural visits is not included. You must also pay bank charges.
Please fill in the application form and return to:
The Danish Cultural Institute
Att: Merete Agger
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