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ONLINE BOOKING


PERSONAL INFORMATION


Last Name *

First Name *

Address *

Zip Code *

City *

Country *

Phone *

Fax *

Email *

Birth date *

Country of Birth *

Sex *	Female Male

Country of Citizenship *

Profession *

Mother Tongue *

Other Languages *

Optional *	Smoker Vegetarian Dont eat porc No pets

Allergies

Your Level of French *	Advanced Intermediate Elementary Complete beginner Beginner

How did you hear about Home Of Languages *


DETAILS OF THE COURSES


Type of course *

Number of Weeks *

Starting Date *

Ending Date *


ACCOMODATION


Type	Appartment Student Residence Hotel Single room Double room Host family

Number of Weeks

Check In *

Check Out *


Transfer from Airport (Extras)



Do you wish a reservation of our shuttle service at the airport?


At your Arrival *	yes no

At your departure *	yes no

Arrival Date *

Arrival Time

Flight Number

Departure Date *

Departure Time

Flight Number

	Enter the code shown