CIOR Language Academy

Last Name*

First Name*

Date and Place of birth*

Passport No*

Address*

Country*

Telephone (mobile phone with country code 00...)*

Email*

Reserve Association name and address*

CIOR Position (if any)*

Rank*

Military affiliation*
—Please choose an option—ActiveReserveRetiredCivilian with military affiliation

If active
—Please choose an option—My MOD/ROA/other will cover my expenses for attending CLAI will pay my expenses for attending CLA

List all prior CIOR Language Academy courses attended and year of attendance*

List all prior CIOR Language Academy scholarships received and year of receipt*

Estimated travel expenses (Please indicate your estimated travel costs in Euro)*

I authorize the processing of my personal data (EU GDPR 679/2016)*