Taflen Cofrestru Registration Form Gorffenaf / July 19-26, 2009 ~ University of Alberta, Augustana Campus ~ Camrose, Alberta If you wish to join us for Cymdeithas Madog's 2009 Cwrs Cymraeg, please use this on-line form to submit your registration information. Each course participant or tag-along must complete a separate form. Please remember that you must send a deposit of $100 (US) to the Registrar via check, money order, or PayPal to complete your registration. You will be billed for the full amount of the course at a date closer to the start. Nol I Dudalen Cartre Cwrs Cymraeg 2009 Back To The Cwrs Cymraeg 2009 Home Page		Contact Information Name: Name as you want it to appear on the course list and on the name tag: Street Address: City: State or Province: Zip Code or Postal Code: Country: Select country Canada United States Other Email Address: Home Telephone (Including Area Code): Cell Phone (Including Area Code) : ========================= Accommodation Gender: Select gender Male Female Student Type: Select residence type Resident Adult Resident Student Commuter Adult Commuter Student Tag-Along Room Request (If Staying In Residence): Select residence room type Double room (2 occupants) Single room (1 occupant) Commuter--no room required Please note that single rooms are limited and will be allotted on a "first come - first served" basis. If you have choosen a double room, have you made arrangements with someone to be your roommate? Select whether you have a preferred roommate Yes No Not applicable If so, with whom? Note: Anyone who requests the rate for sharing a room must provide the name of the roommate with whom he/she will share, or agree to share with another participant chosen by course organizers. Otherwise, the single occupancy rate will apply and be payable. Are you a smoker? Smoker? No Yes ========================= Student Discount Information If you are requesting a student rate above, please let us know a little about your current educational situation: Current Student Status:: I am not a student I am a grade school student I am a high school student I am a university undergraduate student I am a university graduate student Current School Attendance: I do not attend classes I attend classes full time I attend classes at least half-time I attend classes less than half-time ========================= Special Requirements Participating students will need to walk between buildings for course activities. This walk could be up to three blocks on the level. If you have any special needs or requirements, please let us know about them: I do not have any special needs or requirements. We must make appropriate plans ahead of time for your meals in the college cafeteria. If you have any special dietary needs or restrictions (e.g., lactose intolerance, you do not eat red meat, you are a vegetarian, etc), please let us know what you can and cannot eat. Otherwise, the college will not be able to provide suitable meals for you If you have any special dietary needs or requirements, please let us know about them: I do not have any special dietary needs or restrictions. ========================= Closer to the time of the course, we will send you a final payment invoice, which will include order information for optional items: the Cwrs t-shirt, the mid-week Cwrs trip, and any extra nights prior to the course. An Emergency Contact / Medical Information form is available online. Please fill out the online Arrival and Departure form. A list of arrivals and departures is a page on the Google Discussion Group site.. Watch the Cymdeithas Madog Cwrs Cymraeg Goleuni'r Gogledd website for information on the mid-week trip and the course t-shirts. Course Placement Section A To be completed by those who HAVE attended Cwrs Cymraeg Cymdeithas Madog before. Those who HAVE NOT attended a course before should skip down to Section B. To the extent applicable, please list the three most recent years when you have attended Cwrs Cymraeg Cymdeithas Madog and the level of your class (e.g., 2007 - Level 4). At what level do you think that you might be most comfortable this year? If you're not sure, check the Cymdeithas Madog Class Level Guide for an overview of the material covered at each of our levels of instruction. Please note that the former "5+ level" is now called "level 6" while the former "6 level" is now called "Level 7." Choose a level Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 (formerly 5+) Level 7 (formerly 6) If you have attended Cwrs Cymraeg Cymdeithas Madog before, you do not need to fill out Section B unless you have reason to believe that your Welsh has changed greatly since the last time you were on the Cwrs (e.g., if you have studied Welsh extensively somewhere else). Section B To be completed by those who HAVE NOT attended Cwrs Cymraeg Cymdeithas Madog before. Are you a complete beginner? Knowledge of Welsh I am a complete beginner. I have some knowledge of Welsh. Note For Beginners In Welsh: If you have never studied Welsh before and are a complete beginner, you will automatically be placed into Level One. Your placement is now complete. Skip the remaining questions, scroll down to the bottom of the page and click on the "Submit" button to send your placement form to the Placement Coordinator. If you are not a complete beginner, please answer the following questions: Please provide any additional information about your Welsh language background that you would like to share with us (such as previous Welsh instruction apart from Cwrs Cymraeg Cymdeithas Madog, extensive residence in a Welsh-speaking community in Wales, etc). Please write a short paragraph in Welsh telling us a little bit about yourself and/or how you came to be interested in Welsh. Questions and comments: ========================= After submitting this form, please complete requirements to reserve your place on Cymdeithas Madog's Cwrs Cymraeg 2009 by following the instructions on the main Registration page. ========================= Note For Students Under 18 Years Of Age: Any student younger than age 18 on July 15, 2009 who is not accompanied by a parent, adult relative or adult guardian must provide a letter from a parent or legal guardian giving permission to attend Cwrs Cymraeg Goleuni'r Gogledd. This letter should be addressed to the Cwrs Registrar and sent with the student's deposit of $100 (USD) to complete registration in such a case. Thank you for registering on-line for Cwrs Cymraeg 2009. You are now ready to submit your registration form. Please click on the submit button below.
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