Registration Form 2008
Etablissement privé d’enseignement supérieur

Course

30 lessons (60 minutes) + 20 hours activities in French = 50 hours active French / week.
Group of 4 trainees maximum.

Programme A in group
room magnanerie (air-conditioning)
 1650 € / Week
room château (air-conditioning + TV)
 1750 € / Week

Programme B combined
room magnanerie (air-conditioning)

 2210,00 € / Week
room château (air-conditioning + TV)
 2310,00 € / Week
Programme C individual
room château (air-conditioning + TV)
 3700,00 € / Week
     

Accommodation

Full board (Sunday evening –Friday afternoon*)
+ Single room (Sunday evening –Saturday morning)
Nights in the week-end free for a 2week course.
*Dinner is not served on Friday evening

Total amount: €
Dates:
Terms of payment:
1) A 20% deposit* is required upon registration .
2) The outstanding balance* will be due one week before the beginning of the course at the latest.
N.B.: If you decide to leave earlier than planned, the outstanding balance will not be refunded.
Bank transfert:
Credit card VISA:
EUROCARD MASTERCARD AMEX
Please, charger: €
Cardholder:
Card number:
Expiration date : 12/2006
Visual cryptogram (3 last numbers at the back of your VISA or the card verification code of your AMEX)
Cardholder's signature:  
If you have any special request concerning accomodations or meals, please state:
Self-Assessment: beginner = 1, elementary = 2, interm = 3, advanced = 4
Oral comprehension:
Written comprehension:
Oral expression:
Written expression:
Name: Surname:
Date of birth: Place of birth:
Profession: Company:
Address: City:
Country: Zip Code:
Phone:    
E-mail:      

 
I, the undersigned certify that I have perused the registration terms of my course at Millefeuille Provence and that I accept them. 
Date signature:_________________
Millefeuille


*Deposits will only be refunded in cases of absolute necessity.


info@millefeuille-provence.com

 

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S.A.R.L. au capital de 8000 €, RCS Nîmes B 440 226 660 , SIRET 440 226 660 00015, NAF 804 C.