Dutch Language Cafe Registration Form






First name *

Last name *

E-mail *

Date of birth *


DD/MM/JJJJ

Gender *

Male
Female
Other/Rather not say

Address *

Postal Code *

City *

Phone number *

What Dutch level are you? *

Absolute beginner (A0)
Beginner (A1)
Intermediate (A2-B1)
Advanced (B2+)
Native

Are you ok with receiving invitations to events through e-mail (about once a week)? *

I agree

Select membership *