Application Form for a Student/Foreigner - Wrocław na językach świata

This program is addressed to adult (18+) foreigners living in Wrocław or the surrounding area.
Participation in this program is FREE.
The Polish language is taught by volunteers.
We are NOT a language school.
One student can only have one volunteer.

Please, fill out the following form precisely, paying particular attention to the accuracy of your contact details (e-mail address and telephone number).

If you are visually impaired or blind, we provide support at the telephone number +48 504 799 356 (this form contains Google Map and the picture with anti-spam security code).

Your name (required):

Your surname (required):

Sex (required):

Age (required):

E-mail (required):

Phone number (required):

Your Polish level (required):

Your native language (required):

Specify other languages you know (may be according to your own self-assessment):

language 1: , level:

language 2: , level:

language 3: , level:

language 4: , level:

Nationality (required):

Select the area (on the list under the map) in which you want to meet with a volunteer to learn Polish. Click the mouse cursor or press your finger on the colored area on the map to check the zone marking. Here is a detailed list of available locations in the zones (link opens in a new window) (required):

Choose if you want / can meet online with a volunteer:

ONLINE

If you want / can meet with a volunteer face-to-face, select preferred zones (the more zones you choose, the greater the chance of finding a volunteer for you, but please avoid choosing the whole city):

FACE-TO-FACE: AREA AFACE-TO-FACE: AREA BFACE-TO-FACE: AREA CFACE-TO-FACE: AREA DFACE-TO-FACE: AREA EFACE-TO-FACE: AREA FFACE-TO-FACE: AREA GFACE-TO-FACE: AREA HFACE-TO-FACE: AREA IFACE-TO-FACE: AREA JFACE-TO-FACE: AREA KFACE-TO-FACE: AREA LFACE-TO-FACE: AREA NFACE-TO-FACE: AREA OFACE-TO-FACE: AREA PFACE-TO-FACE: AREA QFACE-TO-FACE: AREA RFACE-TO-FACE: AREA SFACE-TO-FACE: AREA TFACE-TO-FACE: AREA UFACE-TO-FACE: AREA VFACE-TO-FACE: AREA WFACE-TO-FACE: AREA X

Preferred meeting days and time with a volunteer (please avoid entering "any day", "any time", etc.) (required):

How did you learn about our program? (required):

Comments:

Declaration of the place of residence (required):

READ: INFORMATION ON PROCESSING PERSONAL DATA BY WROCŁAW INTEGRATION CENTRE (link opens in a new window)

I declare that I read the following information about processing of personal data by the Wrocław Integration Center, understand the content of this information and I hereby give consent for my personal data contained in this application form to be processed.

I acknowledge that Wrocław Integration Center may contact me by phone or email to obtain information on the functioning of a given language tandem / group and other issues related to my participation in the program "Wrocław na językach świata".

I declare that I will not use the contact details of the volunteer for purposes other than organizing language tandem / group meetings implemented as part of the program "Wrocław na językach świata".

I declare that I am an adult.

Input this code: