- 4. Current situation

Employee o o Employee o o Student Unemployed Other (please specify):

- 5. Foreign languages:

languages	level
Very good	Good	Basic

- 6. Other information

Driving o Driving o license: Yes No
Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify):
Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability o F inancial difficulties o Health Problems o Geographical difficulties o Difficulty in learning	Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability o F inancial difficulties
Social problems (eg. Discrimination in any o form, problems with drugs, broken families)	Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability o F inancial difficulties o Health Problems o Geographical difficulties
Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability	Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability o F inancial difficulties o Health Problems o Geographical difficulties o Difficulty in learning o C ultural differences
Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify): o Disability o F inancial difficulties o Health Problems	Do you belong to a group with any fewer opportunities listed below? If so, please explain: o o Difficulty in learning F inancial difficulties o Social problems (eg. Discrimination in any o form, problems with drugs, broken families) problems (eg. Discrimination in any Geographical difficulties o form, problems with drugs, broken families) o o Disability C ultural differences o Health Problems O ther (please, specify): O ther (please, specify):

Allergies: Medicine: Special diet: