Personal Information (Persoonsgegevens)

The * symbol means this data is required.

Surname / Achternaam

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Name / Voornaam

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Gender / Geslacht

Male (Man)

Female (Vrouw)

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Date of birth / Geboortedatum

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Land of birth / Geboorteland

Nationality / Nationaliteit

Contact Information (Contactgegevens)

Street / Straat

House number / Huisnummer

Postcode / Postcode

*

Place of living / Woonplaats

Phone number

*

E-mail address / E-mailadres

Pre-studying information (Voorstudie van informatie)

Primary school / Lagereschool

Secondary school / Middelbare school

High school / Hogeschool

Overig

What is your preferred location to study? / Welke plek om te studeren heft jouw voorkeu?

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Choose your preferred time for the lessons/ Kies de lestijd naar jouw voorkeur

Morning / de ochtend

Afternoon / de middag

Evening / de avond

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Please mention the name of your previous school of language in the Netherlands, But if it's your first time subscribing for Dutch lessons please reply with "new"

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ADAMS UNIVERSAL

Personal Information (Persoonsgegevens)

The * symbol means this data is required.

*

*

*

*

Contact Information (Contactgegevens)

*

*

Pre-studying information (Voorstudie van informatie)

*

*

*