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Personal data

Chinese name

English / Dutch name*

Parents name*

Birth_date

Gender* Boy / Man Girl / Woman

Street + homenumber*

Zipcode*

City*

Mobile telnr.*

E-mail*

Emergency telephone*

Education

Which language do you want to learn?* Mandarin
Cantonese

In which city are you going to follow lessons?* Almere
Amsterdam
Utrecht

Did you previously learned Chinese?* Yes No

If yes, where?

Which book(s) have you learned, until where?

Which language do you speak at home?* Mandarin
Cantonese
English
Dutch
Other

Privacy

I have read and accept the Privacy policy*

Click here to read the Terms and Conditions.

CON may use my photos/videos on the CON website* Yes No

CON may use my photos/videos on the CON facebook page* Yes No

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Thank you for your registration at the Chinese Onderwijscentrum Nederland.
A confirmation of your registration is send to the by you provided e-mail adress.

We will contact you in the 4 weeks prior to your Chinese language lessons.

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