Please complete the registration form:

First name

Family name

Gender

male female

My address (Street, house number, apartment number)

Post code/ zip code

My place of residence

I live in this country

I am a citizen of this country

My e-mail address

My telephone number
(national code-city code-number)

My age

My German skills (estimated)

no (beginner)
poor
good
very good

Packages for school and university students and young people in apprenticeship (< 27 y)

I want to book the following programme:

JU20 (1 week)

JU25 (1 week)

JU40 (2 weeks)

JU50 (2 weeks)

JU60 (3 weeks)

JU75 (3 weeks)

JU80 (4 weeks)

JU100 (4 weeks)

My school,....is called:

I'm studying in this city:

Adults' programmes:

I want to book the following
German language program:

You-select Programme
(units per week)

General German
Special German
Active+Creative Program

Conversation course (units per week)

Units Active+Creative Program

Starting date (according to place offer)

e.g. 25/01/2016

Duration of course in weeks (place offer)

Accommodation (place offer)

Single room
Apartment

Meals (Full board/ half board/ breakfast)

Breakfast/ lunch/ dinner
Breakfast/ dinner
Breakfast only

My questions/special requirements

I would like to get a copy of this registration

yes no

I accept the Terms & Conditions of
The Language Guesthouse

yes no

Attention! Your registration has been submitted not before you can read here: "Your registration has been submitted successfully!"