French-American Exchange - Summer Study Abroad Registration Form


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Summer Study Abroad Registration Form

Last Name

First Name

Present Address:

Street

City

State

Zip

Phone

E-mail

Fax

Permanent Address (if different):

Street

City

State

Zip

Phone

How did you find out about our programs?

Date of birth

Place of birth (City and State)

Student Status

Soc. Sec. No.

Passport No.

Expiration Date

Knowledge of French

	None		Elementary
	Average		Good
	Very good

Desired program duration

	4 week		2 weeks
Other : # of weeks

Preferred dates: From to .

Preferred Location:

	Paris		Nice
	Montpellier		Tours
	Aix-en-Provence		Bordeaux

Desired Accommodation:

1st choice	2nd choice		1st choice	2nd choice
		Family Homestay			Student Residence*
		Efficiency Apt

Note: Please indicate 1st and 2nd choice. Availability varies. * Available July-August in Montpellier; Tours, Bordeaux and Paris.

Activities of Interest: (for use in selecting host family)

	Tennis	Boating	Swimming	Windsurfing	Bicycling
	Theater	Music	Dance	Hiking
Other

I agree that the above information I have provided is true to the best of my knowledge.

I am sending an application check for $50 made payable to: French-American Exchange, 3213 Duke Street #620, Alexandria, VA 22314.

Please charge the $50 application fee to my:

Card holder name

Credit card number:

Expiration date:

Please remember to send us three paper photos by snail mail or one digital photo by e-mail.

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Find out about summer study abroad programs in ...

Aix-en-Provence

Bordeaux

Montpellier

Nice

Paris

Tours

Comments, questions? Send them to info@FrenchAmericanExchange.com