Standard Registration Form – English Version Title*MsMrsMrDrProf.Name of Participant* First name Last name Please enter your name. Please note that if you are applying for a visa and need confirmation of registration from the Language Center, the name given here must be identical to the one in your passport.NationalityAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentiniaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivienBosnia and HerzegovinaBotswanaBraziliaBruneiBulgariaBurkina FasoBurundiCambodiaCamaroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic RepublicCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicDutchEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSüd KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyiaLiechtensteinLithuaniaLuxembourgMacedonienMadagascarMalawiMalaysiaMaledivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovenMonacoMongolienMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNeu ZeelandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSant Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellenSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican StateVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweDate of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you are applying for a visa, please note that the date of birth given here must be identical with the one in your passport. Participant's address* Street Address Address Line 2 City ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Please give your address in Germany. Should the address for the invoice differ, please enter the address for the invoice in the next field.Address for the invoice (if different to above) Street Address Line 2 Town ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Tel. No.*Tel. No. (daytime)Tel. No. (evenings)Email* enter email confirm email Location for lessons*Language CenterCompany premisesAt home (with surcharge)Where would you like the lessons?Language to be learned*ArabicChineseCroatianTchechDutchEnglishFrenchGermanGreekHindiItalianJapanesePolishPortugueseRussianSpanishSwedishTurkishVietnameseWhich language would you like to learn?Type of course*Please selectEinzelcoachingFlexikursIntensive courseSeminarIn-house company courseInterview trainingBusiness EnglishBusiness GermanTaster for seminarsGerman Intensive Course (if applicable)The German Intensive Course: Standard 25 takes place from 08:30 - 13:00 h from Monday to Friday / Student 25 takes place from 08:30 - 13:00 h (only possible with a student's ID or an invitation letter from the University)German: Standard 25 = € 497 per person/per monthGerman: Student 25 = € 437 per person/per monthNo German courseWhich months would like to attend your German course?*Please hold down the CTRL/STRG key on your computer to select more than one month. Providing there is a place available, we will then reserve a place for you on the course.JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberFlexi Courses (if applicable)The Flexi Courses are ongoing and take place in the following frequency and length. They can be joined at any time (except absolute beginner courses) and cancelled by the 15th of the current month (for the next month). Please select the one you would like to attend: Flexi Course = 1x per week / double lesson (90 min.) - €69 per person/per monthBusiness Flexi Course = 1x per week/ double lesson (90min.) - €89,00Double-Flexi Course = 2x per week / double lesson (180 min.) - €136 per person/per monthDouble-Flexi-Plus Course = 2x per week / 3 units (270 min.) - €196 per person/per monthNo Flexi courseOne-to-one Courses (if applicable)Individual CoachingCrash coursePreparation course (topic = your choice)Specialist/Business Seminar (if applicable)Please enter the title of the seminar you would like to attend.Date of the seminar (mentioned above) Your language level*Please mark which level of the language you have at the moment in the drop down menu -if you know it. Otherwise take one of the level tests below (if applicable).NoneA1.1A1.2A2.1A2.2B1.1B1.2B2.1B2.2C1.1C1.2C2.1C2.2Take our online German test Take our online English testPreferred days for class*Please fill in which days you could come to your course. You can select more than one day, if you like. Please use the CTRL/STRG key on your computer to select more than one possible day.MondayTuesdayWednesdayThursdayFridaySaturday (25% surcharge)Sunday (25% surcharge)Preferred times*If you wish to book a one-to-one course or a group course, please let us know which time of day you prefer. Please use the CTRL/STRG key on your computer to select more than one possible day.Daytime - between 8:00 h and 17:00 hEvening - from 17:00 onwardsWeekends - Saturday and/or Sunday (25% surcharge)Early morning - from 07:00 h (25% surcharge)Preferred starting date* When would you prefer to start your course?I heard about the Language Center via:* the internet facebook print advertising a friend / an acquaintance the university an advertising campaign other Additional MessageGeneral Terms and Conditions* I have read and accept the Language Center General Terms and Conditions CAPTCHA TwitterFacebookLinkedInWhatsApp