Registration form - 50+ c ourses


To submit your registration on-line to CIA, please fill in the form below.


  • Unfortunately, the Centre International d'Antibes is not able to guarantee the terms of every request. However, the requests of every prospective student will be given the utmost consideration.
  • Please consult the terms and conditions section before proceeding with this registration form.
  • Thank you very much for your interest in the Centre International d'Antibes. We look forward to receiving and processing your request.


General Information
Last Name*
First Name*
Address*
Town/City
Postal/Zip Code*
Country*
Telephone*
Fax
Email*
Age*
Level of French (minimum A2)
Mother Tongue
Promotion code
  Kindly note that the discount will not appear on the invoice issued by this online registration. Upon receipt of your application, our booking agent will take it into account and deduct it from your payment.

Course and Activities (3 sessions of 2 weeks)
From 25.10.2010 to 05.11.2010
From 23.01.2011 to 05.02.2011
From 15.02.2011 to 28.05.2011
From 13.11.2011 to 26.11.2011

Accommodation with half board from Monday to Friday
Single studio
Double studio
Arrival
Saturday (one extra day)
Sunday
Departure
Saturday
Sunday (one extra day)

Transfers (for a supplement)
Antibes train station Arrival transfer  Departure transfer
Nice airport Arrival transfer Departure transfer

PAYMENT

- If your stay starts in more than 4 weeks: you are required to pay a deposit 200€ per week of stay if you have booked an accommodation or 100€ per week of stay if you have not booked any accommodation.

- If your stay starts in less than 4 weeks: you are required to pay your stay in full.

 
Credit Card :

This form is secured by a SSL protocol, to guarantee a total confidentiality of the information you send us. 
Your bank card information is requested as a guarantee of booking, final payment will be requested by bank transfer.


Card Type :
Card Number
Security code
  (please indicate here the 3 last digits that you can find on the back of your card)
Expiration Date : Month : Year :
Name of Cardholder :
Debit authorization for (in €)
 
For SWIFT bank transfer make the payee :

 
CENTRE INTERNATIONAL D’ANTIBES/ATOLL
Bank name : DEXIA NAMUR
IBAN : BE84-0682-4365-7559– SWIFT ( bc ) GKCCBEBB
 
By certified check, please make the payee :
 

"Centre International D'Antibes"

38 boulevard d'Aguillon

06600 Antibes

France

 

Note : For payments by bank transfer or certified cheque, your registration is only confirmed upon receipt of payment in full.

Please check this box to confirm you have read, understood, and accept Centre International d'Antibes's general terms & conditions.

Do you have any questions? Speak to our online advisor



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