APPLICATION  FORM

ACADEMIC YEAR 2002-2003

(Write in block letters)

 

 

 

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Surname ................................................................................................Name................................................................................................................................

Date and place of birth......................................................................................................................................................................................................................

Telephone: home ...................................................work:..................................................................................................................................................................

Profession and name of the company: ..............................................................................................................................................................................................

.....................................................................................................................................................................................................................................................

Course studying at the moment:.......................................................................................................................................................................................................

.....................................................................................................................................................................................................................................................

Knowledge and level (low/medium/good) of foreign languages:

1)............................................................... 2).................................................................................................................................................................................

Level of Italian course already attended:.............................................................................................................................................................................................

 

 

I apply for one of the following Italian courses:

1-Beginner

2- Intermediate

 3- Advanced                          

 

For one of the following periods:    

First semester: October 7th 2002 - January 24th 2003                        

Second semester:  February 17th 2003 - June 6th 2003

 

Date and Signature:............................................................................................................

Note: This application form, duly filled, should be sent to the Vietnam Italy Friendship Association - 105A Quan Thanh tel 04 8454547 fax 04 8432756-