Clone of "Student Applicant visa" application

Application For "German Language Course Visa "
Language (Short Text)
I. Personal Information
Are you an Agent?*

YesNo
Agent Name
Reference code
Full Name *

First Name Last Name
Birth Date*

DayMonthYear
E-mail Address*
example@example.com
Gender*

MaleFemale
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address اسم الشارع

CityProvince

Postal/Zip CodeCountry
Nationality*

III. Language Skills
What is your German language level?
Do you have a German certificate?*

YesNo
Which certificate do you have for the German language?*
Language Certificate(s):*

Cancelof

V. Declaration
I confirm that, to the best of my knowledge, the information given in this form is correct and complete. If admitted, I agree to the statutes, ordinances and rules of WTG Academy.*

Yes, I agree
Should be Empty: