Registration form

Your identity

Title

Ms Mr

Surname

First name

Date of birth

Nationality

Copy of valid identity document (passport, residence permit, etc.)

Telephone number

Email address

Postal address

Country of birth

Postcode

Town/city

Occupation and/or studies

Have you ever participated in a BMLC training course?

Yes No

If yes, in which year?

Person to contact in case of emergency

Name - Address - Telephone number - Email address

Programme chosen

Choose the course you wish to take

Please specify your choice if necessary

Period

Course starting date

Estimated level

Specify your estimated level of French

When you enrol in a general or specific French programme, your level will be confirmed by an online test that we will send you before the course begins.

Examination

Do you intend to take an examination?

TCF IRN (Intégration Résidence Naturalisation) TCF TP (Tout Public) None

Adaptation

Please let us know if you have any specific learning needs (dyslexia, dyspraxia, attention deficit disorder, etc.)

Please let us know if you require any specific accessibility arrangements (reduced mobility, etc.)

If you have any questions or requests for special arrangements, please contact our disability advisor at the following address: contact@bmlc.fr or by telephone on +33 321 99 43 08.

Payment

Payment method

In cash (to be deposited at the office during opening hours) By cheque (to be deposited at the office during opening hours, made payable to Boulogne-sur-Mer Langues et Cultures) By bank transfer (Bank: CCM BOULOGNE SUR MER / IBAN: FR76 1027 8026 2200 0215 0954 553 / BIC: CMCIFR2A)

Payment must be made in euros. Payments from countries outside the European Union may incur bank charges. These will be your expense.

Acceptance

I declare that I have read and accept the Conditions Générales de Vente et le Réglement intérieur. I confirm my registration in accordance with the information I have provided in the form above.

I declare that I do not object to BMLC using photographs and/or videos of me strictly for the purpose of promoting its activities (brochures, website, social networks).

By submitting this form, I agree that the information entered may be used to contact me. In accordance with the European General Data Protection Regulation, I have the right to access, rectify and delete my personal data by contacting contact@bmlc.fr.

BMLC - REGISTERED OFFICE & POSTAL ADDRESS

21, rue Saint-Louis – BP 774
62327 Boulogne-sur-Mer Cedex – France
telephone: 03 66 25 64 18
e-mail:contact@bmlc.fr

BMLC - LOCALS

34, Grande Rue
62200 Boulogne-sur-Mer
telephone: 03 66 25 64 18
e-mail:contact@bmlc.fr