BLC English

Sunday
Sep 05th
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Online Booking
Online Booking Form

Participant Information

Surname (*)
Please type your full name.
First Name (*)
Please type your full name.
Address (*)
Please type your address.
Town (*)
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Post Code (*)
Please type your post code.
Phone N° (*)
Please type your phone number.
E-mail (*)
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Age (*)
Please type your age.
Nationality (*)
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School Information

School or University
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Name of Teacher
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Address
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Post Code
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Town
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Level of English
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Parent or Guardian

Name
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Parent Address
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Post Code
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Town
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Profession
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Home Phone
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Work Phone
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Mobile Phone
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Emergency contact (friend or relation)

Name
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Address
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Post Code
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Town
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Home Phone
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Work Phone
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Mobile Phone
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Autorisation

I authorise BLC to sanction any urgent medical or surgical treatment.

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If the student is between 15 and 17, can they go out alone at night?

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Enter participant's name.
I wish to book (*)
Please type participant's name

You can check your courses references by clicking on this link
Select your course reference (*)
Please, select a course reference.

International travel



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Sending us this booking constitutes an electronic signature. It guarentees you a reserved place and commits you to sending us (within 72 hours) 3 identity photos and an international money order for 150.00 Euros deposit made out to BLC. These items should be sent to :

Britannic Language Centre - Paris
63 bis rue de Billancourt - 92100 BOULOGNE - France

The balance should be sent to BLC - Paris or settled by any other appropriate method, no later than 1 month before departure. In cases of late booking (within a month of departure full payment is required at the time of booking).
How did you hear about BLC ?
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Confirmation (*)
You must accept the general conditions in order to validate the form.


  
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