 
|
         
|
Please print out this form.
Please register me for:
_____the Full Program ($885 or $650)
_____the Cultural Program ($500)
Please print clearly or type:
Name______________________________
Address____________________________________________________________
Telephone______________________________
Fax______________________________
Email______________________________
Date of birth_____________________________
Place of birth________________________________
Nationality______________________________
Previous education (including dates, area of specialization and degrees earned or expected)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Previous study/knowledge of Yiddish
__________________________________________________________________________
__________________________________________________________________________
Course applied for:
_____ Yiddish I
_____ Yiddish II
_____ Yiddish III
_____ Yiddish IV
_____________________________________________ ____________________
Signature Date
Please post completed application, along with your $100 non-refundable registration fee check made payable to the Vilnius Program in Yiddish, along with proof of full-time student status if applying for reduced tuition, to:
Ms. Roza Bielauskiene
c/o The Jewish State Museum of Lithuania
12 Pamenkalnio St.
2001 Vilnius, Lithuania
About the Program | Academic Program
Cultural Program | Faculty
Accomodations | Tuition and Fees
Application | Contact us
Support the Program | Home Page