Amif participant application form 0917

Page 1

Asylum, Migration and Integration Fund Integration Measures PARTICIPANT CONTACT INFORMATION Name

I.D No. / Passport No.

Surname Address Phone Mobile

Nationality

Ukrainian Chinese Philippines Georgian

E-mail

Gender

Male Female

Level of education

Primary Secondary Post-secondary

Age

Vocational

COURSE PREFERENCES Maltese

English

Beginners Intermediate

Beginners Intermediate

St. Paul’s Bay St.Venera

St. Paul’s Bay St.Venera

Language & Level Preference

Preferred tuition location

Preferred tuition schedule Floriana

AM PM

Floriana

DECLERATION 1.

I declare that all the information in this application form is correct.

2.

I am currently not attending any English and Maltese language tuition funded by EU schemes.

3.

I agree and consent to have my personal data processed by the Local Council Association on behalf of the AMIF project and handed over to third parties for the purpose of processing my application and in order to fulfil its functions by law. As the data subject I have the right to access, rectify and where applicable erase the data concerning myself. LCA undertakes to comply with all the relevant legislation and regulation relating to the handing and processing of personal data in force from time to time. Any personal data disclosed to LCA for the same purpose on any future occasion shall be subject to the same data protection notice.

Signature: ______________________

Date: ________________________ FOR OFFICE USE

Application Received Date

Application Ref. No.


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