application

    form

31-041 Kraków
Mały Rynek 3
tel./fax 012 422 78 57
ul. Starowiślna 1
tel./fax 012 431 02 48


given names
surname
sex
birth date
birth place
nationality
native language
command of foreign languages
profession
address
phone no
e-mail
course type
course date
do you want accommodation
yes no
what type
Dates of accommodation
Have you ever visited Poland
yes no
Have you ever learnt Polish
yes no
How have you learnt about “Mały Rynek” School of Languages

     

    Terms of payment:

     

    1. Payment to the bank account:

      2. Szkoła Języków Obcych „Mały Rynek”
      31-041 Kraków, Mały Rynek 3
      Account number: PL 75 1240 1431 1978 0010 1535 3648

    2. in cash in “Maly Rynek” s main office.

     

    In order to receive confirmation of registration for the course please
    pay a deposit of EURO 150. The full payment must reach the bank
    account of our School before the course start date.

     

    Important notes:

    1. Please remember that registration is valid only upon payment of the
      EURO 150 deposit.
    2. A student should have insurance coverage for hi/her stay in Poland.
    3. The filled in and signed registration card should be sent ( by e-mail,
      fax or mail) to “Mały Rynek” School of Languages not later than
      2 weeks before the course start date
    4. Students under 18 years of age send us their registration card signed
      by their legal guardians and accompanied by a declaration stating that
      the signing person is aware of the terms and conditions of the minor
      student` s attendance of the course and that such person takes full
      responsibility of the minor student` s disciplined participation in the
      course.

     

    I,............................. being the legal guardian of ............................ certify
    hereby that I am aware of the terms and conditions of his/her participation
    in the course of Polish organized by “Mały Rynek” School of Languages
    and I agree to his/her attending such course.

     

    Signature of student                                            Signature of guardian