Student's information First Name: Middle Name: Surname: Preferred Name/Nickname (optional): Home Address (incl. the postcode): Email Address: Telephone Number: Have you attended our CS School Bristol online lessons before? yesno Have you attended Czech/Slovak adult lessons elsewhere before? yesno Please give details: Language Skills Your First Language(s) & Other Languages: Communication in Czech/Slovak Language: basic wordsintermediateadvancedcommunicativeI understand but do not speakother Why do you want to sign up for the course? What is your motivation for learning Czech or Slovak language? Please share with us any information which could help our teachers to plan their lessons (your interestes, hobbies, concerns with regard to learning Czech/Slovak language etc,): Course preference Language: online Czech lessonsonline Slovak lessons Your availability (Day and time): Language level preference: basicelementaryearly intermediateintermediateadvanced We normally run our courses in small groups but some students prefer individual lessons, would you be interested in 1-to-1 online lessons? yesno Would you be interested in face-to-face lessons? yesno Would you be interested in something else in connection with Czech/Slovak language and culture? online art clubonline book clubfilm clubcommunity eventsvolunteering at our eventsother If other, give us details: GDPR Consent I give permission Czech & Slovak Community and School Bristol CIC to keep the above personal records in accordance with the Data Protection Act 2018 for the period of me attending CS School Bristol online sessions? * yesno To comply with the Data Protection Act 2018, we also need your permission before we can take any photographs or make any recordings of you during lessons. Do you give permission for photographs / videos to be taken during lessons for publicity purposes? yesno Δ
