Complete the registration form below

* indicates required fields First Name *

Last Name *

If you are opting for the "Special 2" offer, please enter the name of the other participant *

Street Address

City / Town *

Zip / Postal Code

State / Province

Country *

Age      -- Please Select -- < 25 25-34 35-44 45-54 55-64 65-74 > 74

Gender      Female      Male

Email address *

What is your interest in attending the French Tutor immersion program in Provence?

Your estimated level in French? more information

Which dates would like to attend the French Tutor immersion program *      Select a session date August 31 - Septembe 3 1010 September 7 - September 10 2010 September 14 - September 17 2010 September 21 - September 24 2010 September 28 - October 1 2010 October 5 - October 8 2010 October 12 - October 15 2010

In which industry / trade occupation are you working in?      -- Please Select -- Accounting / Finance Activism Administrative / Clerical Advertising / Marketing / PR Aerospace Agriculture Airlines / Aviation Architecture Arts / Media Automotive Banking / Mortgage Biotechnology Call Center Chemical Construction & Trades Consulting Consumer Products Customer Service Decorating / Design E-Commerce Education / Teaching Electronic Employment / Staffing Energy / Power Engineering Entry-Level Environmental Sciences Executive Management Government / Civil Service Healthcare / Nursing Hospitality / Hotel / Travel Human Resources / Training HVAC Import / Export Industrial Information Tech / Computer Insurance Internet / Web Law Enforcement / Security Legal / Law Related Maintenance / Facilities Mgmt Management Manufacturing Military Mining / Metals Non-Profit / Fundraising Other / Miscellaneous Packaging Pharmaceutical Publishing / Journalism Purchasing / Procurement Radio / Television Real Estate / Property Mgmt Recreation Research Restaurant / Food Service Retail / Fashion / Grocery Sales / Sales Management Science Shipping / Receiving Social Services / Counseling Supply Chain / Logistics Telecom / Wireless / Cable Telemarketing Transportation Utilities Warehouse / Distribution Waste Management Work at Home / Business Opp

Job Title

Do you have any questions about the program? Please describe

I have read the French Tutor Immersion Program agreement