Alliance Française de Buffalo 59 Quail Run Lane Lancaster, NY 14086 I would like to register for 2011 Winter and Spring Session(s): (check one) ___ Novice A (Monday) $350 (14 weeks) ___ Novice B (Tuesday) $350 (14 weeks) ___Intermediate 1(Fall) (Monday) $175 (7 weeks) ___Intermediate 2(Fall) (Wednesday) $175 (7 weeks) ___Advanced (Fall)(Thursday) $175 (7 weeks) I would like to pay for the books I will receive on the first day of class Textbook $26 (required for novice level) Workbook $26 (required for novice level) Textbook $26 (required for intermediate level) Workbook $26 (optional for intermediate level) You do not need to be a member of the Alliance Française de Buffalo to join a French Conversation class. Membership is valid from September 1st to August 31. The membership of first time members joining after January 1st will be valid until August of the following year. After attending a full year of instruction with full tuition, participant can join the Club des Fidèles, and get a discount of 15% on the full tuition (given on the first day of the session only, and only on a full session). In case a student knows ahead of time that he or she will miss one class, a voucher can be issued and used within the year towards a future session. The student needs to inform instructor of which class will be missed prior to the start of the session. No refunds are given. If you have never taken a class with the AFB you are required to take a test on line at www.alliance-us.org/Merlin/Placement.htm. At the end, you will be asked to forward it to our e-mail address which is info@afbuffalo.org. I am not a member and would like to join the Alliance Française de Buffalo: (circle one) ___ Individual ($40) ___ Family ($50) ___ French Teacher ($25) ___ Full-time student ($20) ___supporting ($85) Full Name: _____________________________________________________ Address: ______________________________________________________ ______________________________________________________________ Home Phone Number: ___________________________________________ Work Phone Number: ___________________________________________ Licence Plate Number: __________________________________________ E-mail address: ________________________________________________ As a member, I would like to participate in the following activities
Tuition: ________ Textbook: $26 Workbook: $26 Non-members Registration Fee: $25 Membership: ________ (on a separate check) Total: ____________ Discount: -____________ (Club des fidèles or Voucher) Amount Due: -____________ Merci!
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