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1st ASECU Youth WINTER SCHOOL
Application Form
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* Indicates required question
First name
*
Your answer
Middle name
Your answer
Last name
*
Your answer
Student or Teacher?
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Choose
1st-year Bachelor student
2nd-year Bachelor student
3rd-year Bachelor student
4th-year Bachelor student
1st-year Master student
2nd-year Master student
PhD student
Professor
Other
Sex
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Female
Male
Date of Birth
*
MM
/
DD
/
YYYY
Affiliation
*
Univeristy, Department
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Major (for students and PhD students)
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Address
*
Your answer
City
*
Your answer
Zip
*
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Country
*
Your answer
Email
*
Your answer
Tel.
*
Your answer
Passport Number
100-200 words
Your answer
Identity Card Number
100-200 words
Your answer
Origin (as is mentioned in the document)
100-200 words
Your answer
Travel information
Date of arrival
MM
/
DD
/
YYYY
Date of departure
MM
/
DD
/
YYYY
Means of transport
Your answer
Do you need a Visa to enter Poland?
I need a Visa
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Additional information
Indicate any special dietary needs or/ and food preferences (if applicable):
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