Name and first name (required)
Date of birth (required)
Your address (required)
Your city (required)
Your country (required)
Your nationality (required)
Your email (required)
Which French course do you choose ? Your choiceFrench standardPrivate tuitionDuo tuitionIntensive coursesSurfing language courseGolf language courseThalassotherapy coursesSpecial teen ProgramDELF / DALFA level
How many weeks ? (required)
Date of your stay :
Your level in French : (required) Your choice :BeginnerElementaryIntermediateAdvanced
Which type of accommodation? Your choiceHost family : single roomHost family : double roomApartmentYouth hostelHotel
Date of arrival in your accommodation : (yyyy-mm-dd)
Date of your departure : (yyyy-mm-dd)
If you wish that we book your accommodation, please provide the following information Hotel, residence, single, double room :
Please let us know if you have special diets or food allergies (vegetarian, allergic to dairy products...), any other allergies (such as animal...), if you are smoker.
This information is essential for the host family.
Date of your arrival : (yyyy-mm-dd)
Please enter the following text for under 18: "I, as (father, mother or guardian) of the undersigned student, do hereby authorize the BLCI staff
to consent to any medical act, treatment or hospitalization, if necessary, under the supervision of a licensed doctor or surgeon. I release BLCI from all liability to such actions and take all the responsabilities for them."
If you cannot fill in this form online, then download it, print it, scan it and send it by email.