Inscription 2011

Please send a mail including the following details to

First name:		Second name:
Nationality:		Job:
Telephone:
Email:
Address:
Postal Code:		Town:
Country:		Sex:
Date of birth:
Level in French:   Dates of the stay:   Duration:   Fist name, age & level in French of the child(ren) enrolled in the course:   Accomodation: - Full board at you teacher's - Half board at you teacher's - I don't need accomodation   Observations: Payment to Crédit Lyonnais, bd Bernard de Menthon, 74000 Annecy France IBAN : FR92 3000 2021 5800 0003 9438 H11 SWIFT code: CRLYFRPP 25% (not refundable) to pay on inscription. Code banque Code guichet Numéro de compte Clé RIB 30002 2158 039438H 11
	I will pay the remaining 75% on my day of arrival.

Conformement la loi informatique et liberte du 6 janvier 1978 (article 27),
vous disposez d'un droit d'accès et de rectification aux donnees vous concernant.

E dans l'O - 55 passage des caves - 74290 MENTHON-St-BERNARD - France - - Tel +33 - 450 51 79 74