Language Self-Study Declaration Form
Please complete the Language Self-Study Declaration Form to outline your self-study language learning plan and goals.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Target Language
*
Please Select
Spanish
French
German
Mandarin Chinese
Japanese
Italian
Other
Study Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Estimated Weekly Study Hours
*
Main Study Goals
*
Conversational fluency
Academic purposes
Travel
Professional development
Personal interest
Other
Preferred Learning Resources
*
Textbooks
Online courses
Language apps
Tutors or language partners
Podcasts or videos
Other
Current Self-Assessed Proficiency Level
*
Beginner
Elementary
Intermediate
Upper-Intermediate
Advanced
Planned Duration of Study (in months)
*
Briefly describe your motivation for self-studying this language.
*
Submit Declaration
Should be Empty: