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PERSONAL INFORMATION
Your Name*

Your Surname*

Date of birth (dd/mm/yyyy)*

Gender*
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Citizenship*

Double Citizenship

Country of residence*

Home address (Street address, city, province, region, postal code, country)*

What is your time zone?*
Attention: just to be sure we are on the same page, before providing your answer, go to Google and write “My time zone” in the search field.
—Please choose an option—GMT-12GMT-11GMT-10GMT-9GMT-8GMT-7GMT-6GMT-5GMT-4GMT-3GMT-2GMT-1GMT 0GMT+1GMT+2GMT+3GMT+4GMT+5GMT+6GMT+7GMT+8GMT+9GMT+10GMT+11GMT+12

Phone number*

Email address*

STUDY FORM:
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Will you be in Lithuania at the time of the course?*:

If you are going to be in Lithuania at the time of the course, would you be interested to have some contact activities at the university?:

COURSE INFORMATION

A short letter telling us why you want to join us*

EDUCATIONAL BACKGROUND

Field of study*

Country*

Study cycle:*—Please choose an option—1 (Bachelor)2 (Master)3 (PhD)

Educational institution in original language*

Educational institution name in English*

Programme name*

Year of graduation (yyyy) (expected or final)*

HOW DID YOU FIND OUT ABOUT THIS LITHUANIAN LANGUAGE AND CULTURE COURSE (please be as specific as possible)
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If other: please, specify:

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LANGUAGE SKILLS

Native language*

Please evaluate your current language level according to Common European Framework of Reference for Languages (A1, A2 – beginner, B1, B2 – intermediate, C1, C2 – advanced).

Lithuanian language skills (if you have already attended the courses, insert the last level you have completed or the level provided on any certificate you have)*
—Please choose an option—NoneA1A2B1B2C1C2

English language skills*
—Please choose an option—A1A2B1B2C1C2

Do you apply for the Lithuanian Language and Culture course for the first time?*
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