….………………………………………………………….. Last name First name ….………………………………………………………….. Street ….………………………………………………………….. postal code, city ….………………………………………………………….. Date of birth ….………………………………………………………….. Nationality ….………………………………………………………….. Phone ….………………………………………………………….. Mother tongue ….………………………………………………………….. MuKi 04 I learn German my child too □ – 092 Beginners l A 1.1 (new!) □ 093 Beginners ll A 1.1 □ 094 Beginners lII A 1.1 □ 095 Beginners IV A 1.1 □ 096 Beginners V A 1.2 □ 097 Advanced learners I A 2.1 □ 098 Advanced learners II A 2.2 □ 099 Advanced learners I B 1.1 □ 100 Advanced learners II B 1.2 □ Date Signature
….………………………………………………………….. Last name First name ….………………………………………………………….. Street ….………………………………………………………….. postal code, city ….………………………………………………………….. Date of birth ….………………………………………………………….. Nationality ….………………………………………………………….. Phone ….………………………………………………………….. Mother tongue ….………………………………………………………….. MuKi 04 □ I learn German – my child too 092 □ Beginners l A 1.1 (new!) 093 □ Beginners ll A 1.1 094 □ Beginners lII A 1.1 095 □ Beginners IV A 1.1 096 □ Beginners V A 1.2 097 □ Advanced learners I A 2.1 098 □ Advanced learners II A 2.2 099 □ Advanced learners I B 1.1 100 □ Advanced learners II B 1.2 Date Signature
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