Application form Be sure of the highest standarDs Foreign residentCzech resident First Name Last Name Mobile Number Email Address Title TitleMr.Ms.Mrs.Dr. Gender Gender Female Male Date of birth Country of birth Nationality Passport number Country of passport issue Passport expiration date Native language (L1) Parent name (if student is under the age of 18) Additional comments Language(s) you would like to study : Language(s) you would like to study : English Spanish French Czech Russian Chinese German Portuguese Italian How did you find out about CA Institute? How did you find out about CA Institute? Recommendation Advertisement Website Brochure Google Twitter Instagram LinkedIn Facebook Agent Home address City State / Province / Region Postal / Zip Code Country My billing address My billing address Is different from home address Billing address City State / Province / Region Postal / Zip Code Country I have address in Czech Republic I have address in Czech Republic Yes Czech address City Postal / Zip Code Who will pay for your course? Who will pay for your course?MyselfAn embassy / cultural bureau / foreign governmentMy company Estimated CEFR Level of the language you would like to study Estimated CEFR Level of the language you would like to study A1 - BeginnerA2 - ElementaryB1 - IntermediateB2 - Upper IntermediateC1 - AdvancedC2 - Proficient Group Courses for Adults (3-9 students) Group Courses for Adults (3-9 students)32 x 50 mins = 8,352 CZK16 x 50 mins = 4,640 CZK10 x 50 mins = 2,900 CZK Group Courses for Young Learners (3-10 students) Group Courses for Young Learners (3-10 students)36 x 50 mins = 6,809 CZK18 x 50 mins = 3,780 CZK10 x 50 mins = 2,100 CZK One to One (1:1) One to One (1:1)32 x 50 mins = 16,272 CZK16 x 50 mins = 9,040 CZK10 x 50 mins = 5,650 CZK Your Availability for 1:1 Lessons Courses at Your Place/Company Courses at Your Place/Company1-3 students - 1 x 50 mins = 665 CZK4-6 students - 1 x 50 mins = 765 CZK7-8 students - 1 x 50 mins = 865 CZK9+ students - 1 x 50 mins = 965 CZK Teacher Training/CPD Teacher Training/CPDTEFL/TESOL 180 Basic = 35,050 CZKTEFL/TESOL 180 Full = 36,049 CZKTEFL/TESOL 180 Special = 30,900 CZKCPD - Intensive course - Teaching pronunciation = 7,850 CZK + 2,900 CZKCPD - Intensive course 2 - Teaching vocabulary= 7,850 CZK + 2,900 CZKIntro to teaching pronunciation - 6 hours = 2,800 CZKIntro to teaching vocabulary - 6 hours = 2,800 CZKIntro to in-class assessment - 6 hours = 2,800 CZKTeaching Business English - 6 hours = 2,800 CZKTeaching Young LearnersTeaching Advanced Syntax Intensive Group Lessons (minimum 3 students) Intensive Group Lessons (minimum 3 students)1 Week - 20 Hours = 5,900 CZK1 Week - 25 Hours = 7,250 CZK1 Week - 30 Hours = 8,550 CZK2 Weeks - 20 Hours = 11,600 CZK2 Weeks - 25 Hours = 14,250 CZK2 Weeks - 30 Hours = 8,550 CZK3 Weeks - 20 Hours = 17,100 CZK3 Weeks - 25 Hours = 21,000 CZK3 Weeks - 30 Hours = 24,750 CZK4 Weeks - 20 Hours = 22,400 CZK4 Weeks - 25 Hours = 27,500 CZK4 Weeks - 30 Hours = 32,400 CZK Intensive Group/One-to-One Course (Split evenly) Intensive Group/One-to-One Course (Split evenly)1 Week - 20 Hours = 8,500 CZK1 Week - 25 Hours = 10,625 CZK1 Week - 30 Hours = 12,750 CZK2 Weeks - 20 Hours = 17,000 CZK2 Weeks - 25 Hours = 21,250 CZK2 Weeks - 30 Hours = 25,500 CZK3 Weeks - 20 Hours = 25,500 CZK3 Weeks - 25 Hours = 31,875 CZK3 Weeks - 30 Hours = 38,250 CZK4 Weeks - 20 Hours = 34,000 CZK4 Weeks - 25 Hours = 42,500 CZK4 Weeks - 30 Hours = 51,000 CZK Intensive One-to-One Course Intensive One-to-One Course1 Week - 20 Hours = 10,100 CZK1 Week - 25 Hours = 12,625 CZK1 Week - 30 Hours = 15,150 CZK2 Weeks - 20 Hours = 20,200 CZK2 Weeks - 25 Hours = 25,250 CZK2 Weeks - 30 Hours = 30,300 CZK3 Weeks - 20 Hours = 30,300 CZK3 Weeks - 25 Hours = 37,875 CZK3 Weeks - 30 Hours = 45,450 CZK4 Weeks - 20 Hours = 40,400 CZK4 Weeks - 25 Hours = 50,500 CZK4 Weeks - 30 Hours = 60,600 CZK Additional Comments Conferences Conferences Regional Conference (1,500 CZK) Seminar (300 CZK) Webinar (99 CZK) English for Football English for FootballGroup - Mini package = 2,900 CZKGroup - Full package = 4,640 CZKGroup - Full Season Pass= 8,352 CZKOne to one - Mini Package = 5,650 CZKOne to one - Full Package = 9,040 CZKOne to one - Full Season Pass = 16,272 CZK Summer English Camps for Young Learners Summer English Camps for Young LearnersHalf Day Camp = 2,299 CZKFull Day Camp = 4,199 CZK Summer English Intensive Courses for Teens Summer English Intensive Courses for Teens4 hour intensive including buffet = 6,900 CZKFamily discount * * I have read and understood the Terms and Conditions, and agree to submit a signed copy Submit First Name Last Name Cell Phone Number Email Title TitleMr.Ms.Mrs.Dr. Gender Gender Male Female Date of Birth Parent name (if student is under the age of 18) Comments Language(s) that you would like to study Language(s) that you would like to study English Spanish French Czech Russian Chinese German Portuguese Italian How did you hear about us? How did you hear about us? Recommendation Advertisement Website Brochure Google Twitter Instagram LinkedIn Facebook Agent Home Address City ZIP Address for invoicing Address for invoicing same as above Fakturační adresa City ZIP Who will pay for your course? Who will pay for your course?MyselfGovernment agencyMy company CEFR Level CEFR LevelA1 - BeginnerA2 - Pre-intermediateB1 - IntermediateB2 - Upper intermediateC1 - AdvancedC2 - Proficient Group courses for adults (3-9 students) Group courses for adults (3-9 students)32 x 50 minutes = 8,352 CZK16 x 50 minutes = 4,640 CZK10 x 50 minutes = 2,900 CZK Group courses for young learners (3-10 students) Group courses for young learners (3-10 students)32 x 50 minutes = 6,048 CZK16 x 50 minutes = 3,360 CZK10 x 50 minutes = 2,100 CZK One-to-one (1:1) One-to-one (1:1)32 x 50 minutes = 16,272 CZK16 x 50 minutes = 9,040 CZK10 x 50 minutes = 5,650 CZK Your availability for lessons Courses at your company Courses at your company1-3 students - 1 x 50 minutes = 665 CZK4-6 students - 1 x 50 minutes = 765 CZK7-8 students - 1 x 50 minutes = 865 CZK9+ students - 1 x 50 minutes = 965 CZK Teacher Training Teacher TrainingTEFL/TESOL 180 Basic = 35,050 CZKTEFL/TESOL 180 Full = 36,049 CZKTEFL/TESOL 180 Special = 30,900 CZKCPD - Intensive course 1 = 7,850 CZK + 2,900 CZK Intensive Group Courses (minimum of 3 students) Intensive Group Courses (minimum of 3 students)1 week - 20 hours = 5,900 CZK1 week - 25 hours = 7,250 CZK1 week - 30 hours = 8,550 CZK2 weeks - 20 hours = 11,600 CZK2 weeks - 25 hours = 14,250 CZK2 weeks - 30 hours = 8,550 CZK3 weeks - 20 hours = 17,100 CZK3 weeks- 25 hours = 21,000 CZK3 weeks- 30 hours = 24,750 CZK4 weeks - 20 hours = 22,400 CZK4 weeks- 25 hours = 27,500 CZK4 weeks - 30 hours = 32,400 CZK Intensive group + One-to-one (half and half) Intensive group + One-to-one (half and half)1 week - 20 hours = 8,500 CZK1 week - 25 hours = 10,625 CZK1 week - 30 hours = 12,750 CZK2 weeks - 20 hours = 17,000 CZK2 weeks - 25 hours = 21,250 CZK2 weeks - 30 hours = 25,500 CZK3 weeks - 20 hours = 25,500 CZK3 weeks - 25 hours = 31,875 CZK3 weeks - 30 hours = 38,250 CZK4 weeks - 20 hours = 34,000 CZK4 weeks - 25 hours = 42,500 CZK4 weeks - 30 hours = 51,000 CZK Intensive One-to-One Intensive One-to-One1 week - 20 hours = 10,100 CZK1 week - 25 hours = 12,625 CZK1 week - 30 hours = 15,150 CZK2 weeks - 20 hours = 20,200 CZK2 weeks - 25 hours = 25,250 CZK2 weeks - 30 hours = 30,300 CZK3 weeks - 20 hours = 30,300 CZK3 weeks - 25 hours = 37,875 CZK3 weeks - 30 hours = 45,450 CZK4 weeks - 20 hours = 40,400 CZK4 weeks - 25 hours = 50,500 CZK4 weeks - 30 hours = 60,600 CZK Additional Comments Conferences Conferences Regional Conference (1,500 CZK) Seminar (300 CZK) Webinar (99 CZK) English for football English for footballGroup Mini Package = 2,900 CZKGroup Full Package = 4,640 CZKGroup Season Pass = 8,352 CZKOne-to-one Mini Package = 5,650 CZKOne-to-one Full Package = 9,040 CZKOne-to-one Season Pass = 16,272 CZK Summer English Camps for Young Learners Summer English Camps for Young LearnersHalf day program = 2,299 CZKFull day program = 4,199 CZK Teen Summer Intensive Teen Summer Intensive4 hour intensive including buffet = 6,900 CZKFamily 10% discount * * I agree with the terms and conditions Submit
