REGISTRATION TO LANGUAGE COURSES

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PARTICIPANT(S) :

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Name *

Surname *

Date of Birth

Mise en page 2ème participant

Name 2nd participant

Surname

Date of Birth

PERSON IN CHARGE :

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Name *

First

Last

Phone number

Email *

Adress

Adress Line 1

Adress Line 2

City

State/Province/Region

ZIP Code

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Check the desired laguage(s) :

French Foreign Language
Arabic
English

Days and schedule chosen :

If your preferred schedule does not appear in the program, please write dow the desired day(s) and time(s) below. You will be contacted if a group is formed.