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Pre-registration Form - Português Língua de Acolhimento (Portuguese course)
To complete your pre-registration at the Centro Qualifica do Agrupamento de Escolas Francisco de Holanda, please fill in the following form, as
complete as po
ssible:
* Indicates required question
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Adress
*
Street name, door number, floor, locality
Your answer
Postal Code
*
Your answer
Place Of Birth
*
Your answer
Nationality
*
Your answer
*
Citizen card (portuguese)
Residence title or authorization
Passport
Refugee protection
Citizen card of an EU country
Other:
ID document number
*
Your answer
Expiration Date (if existing)
MM
/
DD
/
YYYY
Emission date (if existing)
MM
/
DD
/
YYYY
NIF (tax ID number)
Your answer
Portuguese Social Security Number (NISS)
Your answer
Phone Number
*
Your answer
E-mail address
*
Your answer
Education Level (attended)
*
Primary school (4th grade)
Elementary school (6th grade)
Middle school (9th grade)
High school (12th grade)
Bachelor’s degree
Masters degree
PhD
Post-doctoral studies
Other:
Education Level (completed)
*
Primary school (4th grade)
Elementary school (6th grade)
Middle school (9th grade)
High school (12th grade)
Bachelor’s degree
Masters degree
PhD
Post-doctoral studies
Other:
Current Professional SItuation
*
Unemployed for less than 12 months
Unemployed for more than 12 months
Looking for a first job
Employee
Self-employed
Inactive - Attending education or training courses
Inactive - Student /Retired
Other:
Starting date (of your current professional situation)
*
MM
/
DD
/
YYYY
If Employed- Employer/ Company
Your answer
Professional Sector
Your answer
Position held/ Main tasks
Your answer
Level you want to attend:
*
A1 + A2 (initiation) or part of this course
B1 + B2 (continuation) or part of this course
Other:
Have you attended a Portuguese course before?
*
Yes
No
If you have, when and where have you taken the course?
Your answer
Do you already speak/write Portuguese?
*
Yes
No
What is your native language?
Your answer
Do you speak other languages?
Your answer
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