Registration form

Last Name:
First Name:
Date of birth:

Place of Birth:

Sex:
Nationality:
Passport number:
Address:
Country:
Phone Number:
Email:
   
Are you a student, salaried employee or other?
 student salaried other
Why are you coming in France?
Professional trip language trip other
Category chosen:
Standard
Superior
Room chosen:

Single room + breakfast
Single room + breakfast + 7 dinners per week
Single room + breakfast + 3 dinners per week
Double room + breakfast
Double room + breakfast + 7 dinners per week

   
Date of arrival:
Date of departure:

Airport transport (rate upon request):

Yes No
 
Do you have a special diet?
Do you have allergies?
Are you a smoker?
 Yes No
Will you accept an animal in the family?
 Yes No
Is this your fist trip to Paris?
 Yes No
What is your French language level?
 Beginner Average Good Fluent
   
Language School chosen
Address of School:
   
How did you learn about FranceStudentHomeStays.com?
Person to contact in case of an emergency?
Personal Observations:
 

Read the Terms and Conditions


Upon receipt of your filled-in registration form, your requirements will be studied carefully.
Upon receipt of your payment, (see Terms and Conditions), the complete name and address
of the Host Family will be provided and France Student HomeStays will inform
the Host Family of your arrival.