French Language School, French Course in Paris, small groups, Verlaine Langue

Enrolment form

Please wait until you have received confirmation of availibility before sending this form.

Payment must be sent with this form.

Last Name
First Name
Nationality
Sex	M -F
Date of birth	(day/month/year)
Profession
Street Address
Post/Zip code
Town
Country
Telephone
Fax

Adress in France
Post/Zip code
Town
Telephone
Fax :
Mother tongue
Other languages spoken

Enrolment

SEMI-INTENSIVE COURSE

      2 weeks: 280 euros
      3 weeks: 330 euros
      1 month: 398 euros
      2 months: 756.20 euros
      3 months: 1074.60 euros
      4 months: 1432.80 euros

I would like to enrol :

from (day/month/year)
to (day/month/year)
(See calendar)

Lessons :

I pay 40% of the total cost of lessons.
OR
I prefer to pay the total cost of lessons.

E-mail
Required field for the payment