Registration

Please complete this form to begin your registration. After this you will be asked to go to paypal to pay your registration fee.

Vos coordonnées

Surname:

First name:

Né(e) le:

Gender:

Height:

Nationality:

Address:

Telephone:

Mobile:

(in case of emergencies)

Email address:

Parents' occupations:

Number of brothers and sisters(with ages):

Secondary number:

(in case of emergencies)

Renseignements d'études

School Year:

Is English your first language of study?

For how many years have you studied English?

Fluency in English:

Have you been to england before?

Which year?

For how long?

Which region?

Profil du jeune

Character:

Hold down "Control", or "Command" on a Mac, to select more than one.

Activities and interests:

Hold down "Control", or "Command" on a Mac, to select more than one.

Musical Instruments:

Clubs, societies, other interests:

Indicate a sport or activity in which your child particularly excels or competes:

Unauthorised activities:

Useful Information:

eg. religious practice, health problems, etc.

How did you hear about Belaf?

Le séjour

Immersion option:

Date du commencement du séjour:

Date de retour:

Les photos

Individual photo:

Individual photo (2):

Conditions

Les conditions du séjour lues et approuvées:

Name of parent: