ALPE - Association de langues pour enfants

Registrations

* Mandatory fields

Family name* :

First name* :

Child's birth date* :

School level* :

Address* :

Zip code* :

Town* :

Private phone * :

Mobile * :

Fax :

Email* :

Confirm email* :

Parent's name* :

Insurance* :

I wish to register my child to the following course starting on the first week of October :

Area* :

Preferred days* :

Preferred Time* :

Sites :

Any questions ? Please call
022 755 21 11 every morning from 9.00 am to 12.00 am.

Sponsorship :

I am sponsored by a new student. Family Name/First Name of the student:

I want to sponsor a new student and benefit from the Fr. 50.- registration fee which will be deducted from my 3rd term.

Name/First Name of the student:

IMPORTANT: I will receive from ALPE a confirmation and payment information by email.

Comments :

ALPE - Association de langues pour enfants. Tél : 022 755 21 11 / 022 755 46 36 – Fax 022 755 46 61 Email : association.alpe@bluewin.ch