Enrolment form

Yes, I would like to enrol for the Dutch as a Second Language course

Level

NT2 level 1
NT2 level 2
NT2 level 2 shortened course for advanced students

Start date

Immediately
Or on

Method of payment

Payment in full, with 5% discount on the tuition fees
Automatic payment in full, with 5% discount on the tuition fees*
Automatic instalment payments*
Non-automatic instalment payments

* my (giro) bank account number is:

Surname
Initials	M F
Street	Number
Postcode
Town
Country
Date of birth
Telephone
E-Mail

I am familiar with, and agree to, the enrolment conditions.