Czech language courses for Ukrainian freemovers and students of Charles University

REQUIRED FIELDS *

Complete the application in Latin script.
Enter your personal information as it appears in your passport.

Identification information

Basic Information

Date of birth:
Passport number:
Cell Phone Number (Czech):
	Contact address in Czech republic
Street and House/Apt. No.:
City:
ZIP code:
Education Complete:
Ukrainian University you study at:
Field of study in Ukraine:
Your current year of study:
I am already registered at a Faculty of CU:	yes no
Faculty you will enrol:
Specify the study programme you will be studying:
Comments:
Level of Czech proficiency on entrance:
Copy of Passport:
	Copy of Passport – the page containing personal data.