MBA France | College France | Student Visa France with BLS

MBA France | College France | Student Visa France

This is an official registration form for BLS classes.
Please complete the below registration form, which you can submit or print and fax to BLS :
33 5 56 51 76 15

If you have already studied French : click here

It is compulsory to fill in the parts with *

Mrs Ms Mr

Surname* :

First name* :

Date of birth* :

Nationality :

Occupation or studies* :

Address* :

City* :

Postal code* :

Country * :

Email* :

Tel. :

Tel. mobile :

Fax :

COURSE

Select your course * :

Dates

Start date* :

End date* :

How did you find out about BLS ? :

ACCOMMODATION

Arrival date* :

Departure date * :

Please choose ONE of the following :

HOST FAMILY
Do you smoke ?	Yes	No
Non-smoking family ?	Yes	No
Vegetarian ?	Yes	No

Allergies or dietary needs :

To help us pick the right family we would like to know a little more about you (hobbies, interests, likes & dislikes, personality, etc.) :

Will you have a car ?

Yes

TRAVEL DETAILS :

This information is indispensable for the host family.

How and when will you be arriving (date + time) ? :

Airplane
Airline company :
Flight N°:

Train
Departing from :
Train N° :

RESIDENCE-APARTMENT
Name of the residence :
N° of people :

FLATSHARING

DEPOSIT

Prices

BLS will only confirm an enrolment, upon receipt of a deposit of 1300 € or full payment.

	A deposit of 1300€ (of which 1000€ refundable only if Visa is refused + 300€ non-refundable registration fees)
	The full payment of my course + accommodation + administration fees		euros

Credit card	Card N° :
	Expiry date :
	The 3 figures on the back of your card :

I will send a cheque for

euros

I will send proof of bank transfer.

I hereby confirm that I have read BLS' Terms & Conditions.

Ce site est déclaré auprès de la Commission Nationale de l'Informatique et des Libertés.
Les informations collectées par l'intermédiaire de ce formulaire sont à l'usage exclusif de BLS.
Vous disposez d'un droit d'accès, de modification, de rectification et de suppression des données qui vous concernent (art. 34 de la loi "Informatique et Libertés" du 06/01/1978). Pour l'exercer, adressez-vous à BLS, 42, rue Lafaurie de Monbadon. 33000 Bordeaux (France)
ou à info@bls-frenchcourses.com