Registration form - French language school Millefeuille Provence

YOUR DETAILS

Name

Surname

Cellphone (only)

Profession

Age

Nationality

Adress

FRENCH SELF EVALUATION

Oral comprehension

Written comprehension

Oral expression

Written expression

YOUR STAY AT MILLFEUILLE

Programme

Full board accommodation

Total pour votre séjour = €

20% deposit to validate your registration = €

Dates

Lenght of stay (in weeks)

Terms of payment

A 20% deposit is required upon registration for private people. The outstanding balance will be due one
week before the beginning of the course at the latest.

Payment method

Bank transfer

VISA

Eurocard Mastercard / AMEX

Amount to charge

Card number

Expiration date

Cryptogram

Comments