What is your full name?
*
First Name
Last Name
What is your email?
*
How can we reach you?
Country
(###)
###
####
How old are you?
How long have you been living in the Netherlands?
What is your nationality?
Which language(s) do you speak at home?
What is your highest level of education?
Do you have any diplomas or degrees from your home country? If yes, please specify.
Have you worked in your home country? If yes, please describe your work experience.
Are you currently working in the Netherlands? If yes, what is your job and where do you work?
Have you taken Dutch classes before? If yes, where and for how long?
Do you already know your language level?
Beginner
A1
A2
B1
B2
C1
Can you say a simple sentence in Dutch? (e.g., "Ik woon in Nederland.")
Can you tell a short story about yourself in Dutch?
Can you read and understand simple Dutch texts?
Can you write in Dutch? (e.g., write a short email)
Why do you want to learn Dutch?
What would you like to be able to do in Dutch?
How much time per week can you dedicate to learning Dutch?
Do you prefer group lessons, individual lessons, or both?
Group lessons
1:1
Combination
How do you prefer to learn?
Do you have a computer or smartphone to practice online?
Do you have internet access at home?
Do you have transportation to reach the lesson location?
Are there any practical things we should know about?
Do you have any family in the Netherlands?
How much contact do you have with Dutch-speaking people?
(e.g., at work, sports, neighbors)
Do you use Dutch in daily life?
(e.g., in shops, with neighbors)
