1 Your identity

Title* (necessary for your certificate in French) Mrs: Miss: Mr:

Surname*

First name*

Date of birth*

Age

Your profession

Your nationality*

Address*

Postal code*

City*

Country*

Telephone No*

Mobile phone

Fax

E-mail*

2 Your Level In French

We would like to know roughly what level you are before you arrive, in order to place you in a small group of your level, on the first day, when you receive information and take a test.

Level of spoken French*

Level of written French*

When did you study French for the last time? ( When? For how long ? Using which text/workbooks?)

Do you have a degree in French?* (If ‘yes’, please be specific)

Yes : No :

Your mother tongue?*

Other languages spoken?

3 Your choice of course and your objectives

What type of course do you want?*

Wine course (In addition to your French course)

Number of weeks required*

Starting Date*

For what reason do you wish to learn or perfect your French*:

For your work
For pleasure
For your studies
To prepare yourself for an exam and if so which exam?
For another reason (please be specific)

5 Accommodation

Do you want CLE to find you some accommodation?*

Yes No

How did you find out about CLE?*

6 Secure your enrollment

To secure your enrollment, please pay a deposit of 300 EUROS.

Methods of payment :

By online paiment:

By Travellers cheques, eurocheque or a cheque made out in Euros to the order of CLÉ and to be sent to CLE, 7-9 place de Châteauneuf, 37000 Tours, France.

By bank transfer to our account: 001 21 909550 50
Bank code: 18707 - Branch code: 00620
Address: Banque populaire Val de France 23, rue Nationale - 37000 TOURS - FRANCE
IBAN: FR76 1870 7006 2000 1219 0955 050
SWIFT: CCBP FR PP VER, account number: 001 21 909550 50

I certify that I have read and agree to the general conditions of enrolment to the school.*

If you want to stay with a French family, please reply to the following questions. We will send your requirements to a family who will make contact with you.
Do you have any allergies?
Do you smoke ?*	Yes : No : If ‘Yes’ and we can’t find you a family of smokers, will you agree to smoke outside? Yes : No :
Do you have any special eating requirements? (If ‘Yes’ please specify)
What type of family would you prefer? Be precise with your choice. Indicate from 1 to 6, with 1 being your first choice.
A family with people of your own age A family with young children A family with teenagers A couple without children A single person A family with several other students – you will be placed with this type of family only if it your first choice of family
What are your hobbies and interests?*
How would you describe yourself?
1: Timid Reserved Outgoing Chatty	2: Intellectual Sporty both