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french immersion in paris		 Paris Summer Study, Inc.
Application Form

Please complete this on-line application and click the submit button below or you may print out this PDF file and fax or mail it to us here.

We will confirm receipt of your application as soon as possible. (If you should fail to receive your confirmation please email, call or write to our main contact points listed on our contacts page.)

Paris Summer Study, Inc.
on-line Candidate Application

Session I am applying to:
Title
First Name
Middle Initial
Last Name
Phone
Cell
Contact Time
Email
Address
City
State
For international addresses, please select "Other" in the state field and pick your country from the dropdown list below.
Country
Zipcode
Permanent Mailing Address
(if different from current address listed above)
City
State
For international addresses, please select "Other" in the state field and pick your country from the dropdown list below.
Country
Zipcode
Birth Date
 (mm/dd/yyyy)
Education Level
GPA
Current Education Institution
Overseas Insurance
(If yes, you must show proof of coverage)
(If no, you are REQUIRED to obtain International Healthcare coverage)
I am interested in renting a mobile phone while in Europe
Payment Method
Where did you hear about us?


© 2006 - 2009 Paris Summer Study, Inc.
PO Box 6023
Woodbridge, Virginia 22195
info@parissummerstudy.com
571-215-6580