The Language StudioInc. is planning linguistic stays in France in the following two locations:

1. Stay at a castle in the countryside of France, or
2. Stay in the city of Paris

Please fill in the following information if you feel that such a venture might be of interest to you. We will place your name on our waiting list and you will be notified once we have finalized the details of the France Linguistic Stay.

First Name:     Last Name:

Telephone:             Email:

I am over 18 years of age: Yes No

Address:

Province:      Country:

Location Preference: Castle in the Countryside   Paris

Preferred length of stay:  two weeks   three weeks   one month

Estimated Level of French (choose one):   Beginner_I Beginner_II Intermediate_I Intermediate_II Advanced_I Advanced II <\SELECT>

Other/Comments: