CREAM - Creative audiovisual media - Application form
I have read and agree to the
Terms and Conditions
and
GDPR
*
I agree
Accommodation *
I wish to stay in a triple room
I do not need accommodation
Estimated date of arrival *
Estimated date of departure *
Name *
Surname *
Date of birth *
Place of birth (city) *
Place of birth (country) *
Citizenship *
Sex (information needed for accommodation) *
Female
Male
Passport number *
Email address *
Phone number including country calling code *
Do you want to join our Friday trip to Prague? *
Yes, I do.
No, I don’t.
Do you want to join our Friday trip to Viena? *
Yes, I do.
No, I don’t.
Do you want to join our Friday trip to Krakow? *
Yes, I do.
No, I don’t.
Do you want to join our Friday trip to Mikulov? *
Yes, I do.
No, I don’t.
Permanent address / Domicile
Street address *
House number *
ZIP / Postal code *
City *
Region *
Country *
English level (
according to CEFR
) *
Allergies (if so, please specify)
Emergency contact name *
Emergency contact number *
Comments
Information for ECTS credits
Name of your home university
Address of your university
Type of degree (Bachelor’s / Master’s / PhD)
Study programme / major
Your current year at university (e.g. 2nd year)
Discount code
Total amount:
System Settings - Hidden
External Id
Price
Return Url
Payment Gate Return Url
Action Id
Action Secret
Under Action Id
Under Action Secret