C. Fill the form below according to the information given.

Brazilia, September 17th 2017.

My name is Elena, Elena Sandra Sanchez. I am really interested in joining as a participant in

Masoura Summer English course in Masoura University which will be held from May to June 2017.
I was born in June 3rd 2000. I live at Rua Sao Luis, 67678 Brazilia, Brazil. I am curently
studying in El Salvador Public High School in my third year.I am interested in a conversational course
as me and my family are going move to the US by the end of the year. I had planned to enroll in an
English Cultural and Literature studies in a university in USA after i graduate from high school.
I could describe myself as being a very responsible person, mature, honest and friendly,
highly organised, hands on work and trustworthy.I'm confident taking care of responsibilities given
to me but moreover I am always ready to learn new things.
Please consider my application, and would really appreciate it if you approve my application.
I am available for any information, so please contact me on my mobile at: 073-8887-65, Home: 088-
456-768 or E-mail me at: sanchez-elena@gmail.co.brz. And thank you.

PART A: PERSONAL DATA

Full Name:

Date of birth:
(d) (m) (y)
Postal Address:

E-mail Address:

Phone:
(Home) (Work) (Mobile)

Are you?: Still Stuying? /Working?

School: Job:
Faculty: Place of Work:
Specialization:

PART B: COURSE PREFERENCES

General: Conversational: TOEFL:

PART C: PARTICIPANT DECLARATION

 I hereby declare that the Signature:

information given above is true
to the best of my knowledge
and is to be verified when
applying. Date:
( Day / Month / Year )