L&C Sprachferien

Please fill out the following form to apply for one of our short-term programs.

Program

Host Country:

Program No.

Start of program (DD.MM.YYYY):

End of program (DD.MM.YYYY):

Applicant

Family name:

First name/s:

Date of birth (DD.MM.YYYY):

City + Country of birth:

Nationality:

Street address:

Postcode:

City:

Country:

State:

Private phone (mobile):

E-mail address:

Sex:

Height (in cm):

Weight (in kg):

T-Shirt-Size:

Please attach a recent, smiling photo here:

Please note: Only pictures smaller than 5 MB can be uploaded. If you cannot upload a photo, please send it to ICX via Mail.

Hobbies

List any hobbies, sports or other activities you participate in. Also, state any musical instruments you play or (artistic) interests you pursue. Indicate frequency and skill.

Hobby:

Frequency:

Skill:

Hobby:

Frequency:

Skill:

Hobby:

Frequency:

Skill:

Languages

Indicate languages you speak and/or have studied and explain your proficiency.

Language:

Years studied:

Proficiency:

Language:

Years studied:

Proficiency:

Language:

Years studied:

Proficiency:

Emergency Contact

Person to contact in case of emergency (if we cannot reach your legal guardians).

Family name:

First name/s:

Street address:

Postcode/City:

Phone:

Mobile phone:

Business phone:

E-mail address:

Relationship:

Family Album

On this page place photos showing you and your family and friends in the places you live or frequently go to. This is an album for your host family so that they can get an idea of the way you live.

Please note: Only pictures smaller than 5 MB can be uploaded. If you cannot upload any photos, please send it to ICX via Mail.

Photo:

Describe the photo:

Photo:

Describe the photo:

Letter to your Host Family

Your host family is interested in knowing about you. Please write them a brief letter in the target language (english, french, etc) describing yourself and your interest in participating in a cross-cultural program.
It will be helpful if you write about your relationship with family members and friends, your study and personal habits, your ability to handle difficult situations, your home and educational life and your future plans.
Please upload your finished letter below.

Upload your letter here:

Please note: Only files smaller than 5 MB can be uploaded. If you cannot upload the file because of an error, please send the letter to ICX as soon as possible.

Airport

From which major airport in Germany would you like to start your flight?

How did you learn about ICX

How did you learn about the program?

Declaration

Declaration of the student:

It is my own decision to participate in the program, and I confirm that all statements correspond to the truth and have been made conscientiously. I have read the ICX Privacy Policy under https://icxchange.de/datenschutzerklaerung and I agree to the processing of my personal data.

Declaration of the student:

Yes

Declaration of the parents or legal guardians:

The participation of our son/daughter in the ICX program is with our approval. We agree to authorize ICX, its partner organization and/or the host family to act for us in an emergency, accident or illness during the period of time our son/daughter is involved in the ICX program. I/We have read the ICX Privacy Policy under https://icxchange.de/datenschutzerklaerung , and I/we agree to the processing of my/our data and the data of our son/daughter.

Declaration of the parents or legal guardians:

Yes

Bitte dieses Feld NICHT ausfüllen!

Language & Culture-Sprachferien (USA, Kanada, Japan, China, England, Irland, Spanien)

Please fill out the following form to apply for one of our short-term programs.

Legal Guardian

Legal Guardian

Siblings

Declaration of the student:

Declaration of the parents or legal guardians:

L&C Sprachferien