Application Form
Please complete this Application Form and return it to International House Lisbon by fax, mail or email together with your deposit of €300

First Name:.............................................................

Male:..........  Female.................   Age.................

Address:..................................................................

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Nationality...............................     Profession.......................................

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Knowledge of Portuguese

Speaking and Listening

          None.........A little..........Average..........Good............

Reading and Writing

         None.........A little..........Average..........Good............

Portuguese Learning Profile

If you have learnt some Portuguese please provide us with further details:

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Knowledge of Other Languages

English.............   French.............  German  ..............   Spanish.............  Others....................

Type of Course Required

1:1...........   Group...........   From......../.........to........../.............

Type of Accommodation Required

Home Stay..........  Pensão...........  ***Hotel.............  ****Hotel............  None............

Smoker.........  Non-smoker...........Allergies:..................................................................................................................................
Please note that there is a standard accommodation fee of €60.