Vacation Program Registration Form 2011

PERSONAL DETAILS

Mr Mrs Ms Dr
Surname


Gender

Medical conditions

First Name

Date of birth

Country of Birth

Nationality
Profession/Occupation
Dietary requirements:

Arriving in Crans-Montana by:

Car
Bus
Funicular
Unknown

Estimated arrival time:

 

   
CONTACT DETAILS

Address

City/Suburb

State/Province

Country

Postcode
Mobile (incl country & area code)
E-mail
Tel (incl. country & area code)
Fax (incl. country & area code)
EMERGENCY CONTACT DETAILS

Mr Mrs Ms Dr
Name

Tel (incl. country & area code)

Mobile (incl. country & area code)

Address
City/Suburb
Country
Postcode
   
     
LANGUAGE EXPERIENCE
If you have some knowledge of French, please indicate your level according to the “Common European Framework of Reference for Languages”:

Estimated Level:

Absolute beginner
A1
A2
B 1
B 2
C 1
C 2

 

 


Mother tongue

 

Other languages

LEVEL OF SKIING
 

SKI:

Absolute beginner
Beginner
Intermediate
Advanced

 

 


 
LEVEL OF GOLF
 

GOLF:

Absolute beginner
Beginner
Intermediate
Advanced

Handicap

 

 


 
ENROLMENT *It is possible to combine these courses, eg. 2-week Premier + 2-week French+Golf
COURSES, DATES AND PRICES FOR 2011

 

  2 Week Courses Price Deposit Balance

Premier

(French+Culture/Recreation)

14 DAYS

2 January – 16 January 2011 CHF 3,700 CHF 1,110 CHF 2,590
9 January – 23 January 2011 CHF 3,700 CHF 1,110 CHF 2,590
16 January – 30 January 2011 CHF 3,700 CHF 1,110 CHF 2,590
30 January – 13 February 2011 CHF 4,200 CHF 1,260 CHF 2,940
13 February – 27 February 2011 CHF 4,200 CHF 1,260 CHF 2,940
27 February - 13 March 2011 CHF 3,700 CHF 1,110 CHF 2,590
6 March - 20 March 2011* CHF 3,700 CHF 1,110 CHF 2,590
13 March - 27 March 2011* CHF 3,700 CHF 1,110 CHF 2,590
20 March - 3 April 2011 CHF 3,700 CHF 1,110 CHF 2,590
27 March - 10 April 2011 CHF 3,700 CHF 1,110 CHF 2,590
3 April - 17 April 2011 CHF 3,700 CHF 1,110 CHF 2,590
12 June - 26 June 2011 CHF 3,700 CHF 1,110 CHF 2,590
26 June - 10 July 2011 CHF 3,700 CHF 1,110 CHF 2,590
10 July - 24 July 2011 CHF 3,700 CHF 1,110 CHF 2,590
24 July - 7 August 2011 CHF 3,950 CHF 1,185 CHF 2,765
7 August - 21 August 2011 CHF 3,700 CHF 1,110 CHF 2,590
14 August - 28 August 2011 CHF 3,700 CHF 1,110 CHF 2,590
4 September – 18 September 2011 CHF 3,700 CHF 1,110 CHF 2,590
25 September – 9 October 2011 CHF 3,700 CHF 1,110 CHF 2,590
9 October – 23 October 2011 CHF 3,700 CHF 1,110 CHF 2,590
23 October – 6 November 2011 CHF 3,700 CHF 1,110 CHF 2,590
4 December – 18 December 2011 CHF 3,700 CHF 1,110 CHF 2,590
None      

French+Golf

14 DAYS

12 June - 26 June 2011 CHF 5,400 CHF 1,620 CHF 3,780
26 June - 10 July 2011 CHF 5,400 CHF 1,620 CHF 3,780
10 July - 24 July 2011 CHF 5,400 CHF 1,620 CHF 3,780
24 July - 7 August 2011 CHF 5,650 CHF 1,695 CHF 3,955
7 August - 21 August 2011 CHF 5,400 CHF 1,620 CHF 3,780
14 August – 28 August 2011 CHF 5,400 CHF 1,620 CHF 3,780
4 September – 18 September 2011 CHF 5,400 CHF 1,620 CHF 3,780
11 September – 25 September 2011 CHF 5,400 CHF 1,620 CHF 3,780
25 September – 9 October 2011 CHF 5,400 CHF 1,620 CHF 3,780
None      

French+Skiing

14 DAYS

2 January - 16 January 2011 CHF 4,500 CHF 1,350 CHF 3,150
9 January - 23 January 2011 CHF 4,500 CHF 1,350 CHF 3,150
16 January - 30 January 2011 CHF 4,500 CHF 1,350 CHF 3,150
30 January – 13 February 2011 CHF 5,000 CHF 1,500 CHF 3,500
13 February – 27 February 2011 CHF 5,000 CHF 1,500 CHF 3,500
27 February - 13 March 2011 CHF 4,500 CHF 1,350 CHF 3,150
6 March - 20 March 2011 CHF 4,500 CHF 1,350 CHF 3,150
13 March – 27 March 2011 CHF 4,500 CHF 1,350 CHF 3,150
None      

French+Hiking

14 DAYS

12 June - 26 June 2011 CHF 3,700 CHF 1,110 CHF 2,590
26 June - 10 July 2011 CHF 3,700 CHF 1,110 CHF 2,590
10 July - 24 July 2011 CHF 3,700 CHF 1,110 CHF 2,590
24 July - 7 August 2011 CHF 3,950 CHF 1,185 CHF 2,765
7 August - 21 August 2011 CHF 3,700 CHF 1,110 CHF 2,590
14 August - 28 August 2011 CHF 3,700 CHF 1,110 CHF 2,590
4 September - 18 September 2011 CHF 3,700 CHF 1,110 CHF 2,590
11 September - 25 September 2011 CHF 3,700 CHF 1,110 CHF 2,590
25 September – 9 October 2011 CHF 3,700 CHF 1,110 CHF 2,590
None      
  4 Week Courses Price Deposit Balance

French+Culture

28 DAYS

27 March - 8 May 2011 CHF 7,400 CHF 2,220 CHF 5,180
12 June – 10 July 2011 CHF 7,400 CHF 2,220 CHF 5,180
4 September - 9 October 2011 CHF 7,400 CHF 2,220 CHF 5,180
None      

French+Skiing

28 DAYS

2 January - 30 January 2011 CHF 9,000 CHF 2,700 CHF 6,300
27 February - 27 March 2011 CHF 9,000 CHF 2,700 CHF 6,300
None      

French+Golf

28 DAYS

12 June - 10 July 2011 CHF 10,800 CHF 3,240 CHF 7,560
4 September - 9 October 2011 CHF 10,800 CHF 3,240 CHF 7,560
None      
Short Courses Specials Price Deposit Balance

6-night Easter Special

21 April - 27 April 2011 CHF 1,650 CHF 495 CHF 1,155

French+Culture/Recreation

26 June - 3 July 2011 CHF 1,850 CHF 555 CHF 1,295

French+Golf

26 June - 3 July 2011 CHF 2,700 CHF 810 CHF 1,890

French+Skiing

26 June - 3 July 2011 CHF 2,250 CHF 675 CHF 1,575

French+Hiking

21 August - 28 August 2011 CHF 1,850 CHF 555 CHF 1,295

 

None      
* 19th March - Public Holiday

PAYMENTS* All payments are to be made in Swiss francs (CHF)  
  Deposit on registration - 30% Balance of payment 30 days prior to commencement
TOTAL COST DEPOSIT BALANCE
     
Group discounts are applicable to a minimum of six clients enrolled in the same course and level. Please Enquire.
     
Payment -
By IBAN/BIC — Electronic Bank Transfer to:    
 
Account Name: Académie de français Crans-Montana Sàrl    
Account No: 0182-983948-91-1    
IBAN: CH 96 0483 5098 3948 9100 1    
BIC SWIFT Code: CRESCHZZ12A    
Bank: Credit Suisse 8070 Zurich Switzerland    
Branch: Crans–Montana, CH-3963    
     
*If payment is made by bank transfer, all bank fees and charges are the responsibility of the participant.
 
I have read and understood, and I agree to be bound by, the Terms and Conditions.
     
By Submitting the registration Form, I acknowledge that I have read and understood, and that I agree to be bound by, the Terms and Conditions
Alternatively, you may wish to post or fax this Registration Form. Please click for printable format.

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