Alliance Française of Birmingham
Springtime in Paris 2018 Registration Form


VERY IMPORTANT - PLEASE PRINT YOUR NAME EXACTLY AS IT APPEARS IN YOUR PASSPORT. PLEASE SEND A COPY OF THE FIRST PAGE OF YOUR PASSPORT WITH REGISTRATION FORM.
THANK YOU.

(Please complete a separate form for each person traveling)

Last:________________________ First:___________________ Date of Birth:___________________

Address:________________________________________________________________

City:________________________ State:_____________________ Zip:_____________

Phone: Home_______________ Work______________ Email:____________________

Please circle: UAB employee? YES / NO Alliance Française Member? YES / NO
(Online membership form available at: www.afbirmingham.org)

SINGLE / TWIN / DOUBLE - YOUR ROOMATE:_______________________________________________
(1 bed) (2 beds) (1 bed)

I DO NOT HAVE A ROOMATE BUT WOULD LIKE TO SHARE A ROOM:___________________________

Days / Nights
Dates-March 2017
Total Cost for UAB students
(Double occupancy)
Total Cost for Alliance Française members
(Double occupancy)
Single room supplement

Deposit
(no refund after 11/16/17)

Due by 11/14/17

First Payment

Due by
12/12/17

Final Payment

Due before 01/16/18

8/7
3/10 - 3/18
UAB Spring Break
$1,949.00
$2,199.00
$600.00
$299.00
$1,000.00
Balance

PARIS BY NIGHT CITY TOUR $50.00
YES / NO
(Don't send money for now, just circle if you are interested).

Please Mail This Form with Deposit of $299.00 (per person, non-refundable) before November 14, 2017.

(Please add $50.00 if you are not a UAB employee, UAB student, or an Alliance Française member)

Make Check Payable To: Alliance Française of Birmingham
Mail to: 413 Clermont Drive, Birmingham, AL 35209


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