ENROLLMENT FORM PERSONAL DATA First Name Middle Name Last Name Mother’s First Name Father’s First Name Date of Birth: DayMonthYear Place of Birth Citizenship Passport Number CURRENT ADDRESS Street Name Home Number Apartment Number Area Code City Country MAILING ADDRESS (if different from above) Street Name Home Number Apartment Number Area Code City Country CONTACT Stationary Phone Number Mobile E-mail CHOSEN DEPARTMENT DEPARTMENTSCinema Makeup, Visage and Styling (2 years)Cinema Special Effects (SFX), Makeup and Prosthetics (2 years) PAYMENT OPTION PayeeIndividualCompany Form of PaymentCashMoney Transfer HIGH SCHOOL School’s Name School’s Location Year of Graduation I hereby authorize Mr./ Mrs with ID card number to receive any information about the course of study, to collect my documents, and to sign an annex to terminate the contract. I hereby confirm the correctness of given data and agree for processing of my personal information by the Dziewulscy International College in accordance with the Personal Data Protection Act. I acknowledge that the payments made are not refundable in any case.
