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      Center: Trivandrum Kochi
  
 


                                     Application form for the classes

Your registration will be effective only after payment has been received and you will be notified that a place has been reserved for you. Fees once paid are not reimbursable.


(PLEASE USE BLOCK CAPITAL LETTERS)


Surname :

Miss Mrs. Mr.
       
Name :    
       
Address :  
 
  Pin :
       
Date of birth : day / month / year
       
Place of birth :    
       
Nationality :    
       
Profession :    
       
Blood Group :    
 
Phone :
Resi :   
Off :      
       
E-mail :    
       
Previous level completed at Alliance française (if any):
   
       
Class enrolled : Timing :
     
Regular Fast-Track Week-End Private Tuition
 
Crash Late-Evening Children's Course Special Classes
 
     

I ……………………………………….……………… certify that I have read the conditions and that I accept them.
     
Date : Signature
     
Alliance Franηaise de Trivandrum, Sudharshana
Forest Office Lane, Vazhuthacaud,
Trivandrum - 695 014
Phone: 0471 2320666 / 2320777 Fax : 0471 2320088
Email: aftinfo@afindia.org
Visit us at www.afindia.org/trivandrum
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aftlibrary@afindia.org
 
     

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