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Portuguese

Application Form


Please complete this Application Form and return it to International House by fax, post or email together with a deposit of €300

First Name:...................................Family Name:............................................................................................
Male:                Female:                 Age:............Nationality...................Profession............................................
Address:.......................................................................................................................................................

....................................................................................................................................................................

Knowledge of Portuguese

Speaking and Listening

None             A little             Average             Good

                                         Reading and Writing


None             A little             Average             Good

Knowledge of Other Languages

English              French              German              Spanish              Others...........................................................             

Type of Course Required

1:1             Group              From........./.........to.........../............        

Type of Accommodation Required

Homestay             Pensão             ***Hotel           ****Hotel              None       

Are you a smoker             non-smoker      ?   If you have allergies please state..........................................................

Please note that there is an accommodation booking fee of €60.