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Application form for the courses of Caminito.Cz

couple   -    single

		leader		follower
Name:	*		*
Surname:	*		*
Sex:	*	- man    - woman	*	- man    - woman
E-mail:	*		*
Language:		- EN    - CS		- EN    - CS
Telephone:	**		**
Course:	*	7pm 8pm 9pm 10pm Po   Lower intermediate A Beginners A   Út     Beginners B       St   Intermediate Beginners dancers   Čt   Advanced Lower intermediate B   repletion of the courses
Payment:	*	bank transfer    cach
Note:		If you are interested in the FULL-PASS (3 courses, i.e. 36 classes, + all practicas during any three consecutive trimesters: CZK 7000,- / person), mention it in this note.

*   These fields must be filled.
**    Fill when paying via bank transfer (this phone number shall be used as the identification number of the transaction).

Changed: 17.8. 2010 17:37:23

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