ADULTS

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FRENCH COURSE REGISTRATION FORM

Mme. (Mrs.) Mlle. (Miss) M. (Mr.)

FICHE DINSCRIPTION COURS

Renseignements (Applicant Details)

Titre (Title) Nom (Last Name) Prnom (First Name and Other Names) Date de naissance (Date of Birth) Nationalit (Nationality) Groupe sanguin (Blood Group) Profession (Profession) Employeur / tablissement scolaire (Employer / Educational Institution) Adresse professionnelle (Office Address) Adresse personnelle (Mailing Address)
House # ________________________ Apartment # _____________________ Road # _________________________ Area # __________________________ Postcode _______________________ District __________________________ Student Business Service (Govt. / Non Govt. / MNCs / TNCs / NGOs / UN / Journalist) Housewife Other ___________________________________
D D M M Y Y Y Y

Ml (Email Address) Numros de tlphone: domicile (Home Telephone) professionnel (Office Telephone) portable (Mobile/Cellular) Comment prfrez-vous tre contact? (How do you want to be contacted?) Quelles langues parlez-vous? (Which languages do you speak?) Jusqu quel niveau souhaitez-vous apprendre le franais? (How far are you willing to learn French?)

+ 8 8 - 0 2 + 8 8 - 0 2 -

Phone

Mobile

Text Message

Email

Bangla

English

Hindi

Spanish

Arabic

German

Beginners DELF-A1 Independent DELF-B1 Fluency (DALF-C1/C2) Immigration

Intermediate DELF-A2 Advanced DELF-B2

Adding Foreign Language For Pleasure

Discover New Culture

Pourquoi voulez-vous apprendre le franais? (Why do you want to learn French Language?) Comment avez-vous connu lAlliance Franaise? (How did you know about Alliance Franaise?)

Professional Purpose

For Higher Studies English Newspaper Advertisement Friends Leaflets Posters

Bangla Newspaper Advertisement Magazine Advertisement Housewife Banners

Communication Products (Pen, T-shirts ...)

Page 1 of 2 ends here, please turn to page 2.

ADULTS
www.afdhaka.org

16+

Compltez cette fiche EN MAJUSCULES en utilisant un stylo NOIR ou BLEU (Complete this form using either a BLACK or BLUE pen in CAPITAL LETTERS)

Rglementation (Rules and Disciplines)

Students are requested to read the following Rules and Disciplines and sign at the end of the form. 1 2 3 4 5 6 7 8 The registration form has to be filled up with correct name spelling and date of birth. 2 copies of recent photographs are compulsory to submit at the time of registration. The total course fees are to be paid in full in advance. No shifting is allowed after registration. Withdrawal or refund of course fees are allowed within 7 days from the date of session started. In that case, an administrative charge of 500 BDT will be deducted from the fees. Every student has to have the original textbook in class (Photocopied books are not allowed). Every student has to have the student Identity card (ID) on the premises of AFD. ID card can be reissued by paying a fine of 50 BDT (1 copy stamp sized photograph is required). The grading system for AFD exams only are: 1. 2. 3. 4. 5. 8 9 Between 50 to 60 points: Between 61 to 70 points: Between 71 to 85 points: Between 86 to 94 points: Between 95 points and above, Passable/Passed Assez bien/Not Bad Bien/Good Trs bien/Very Good Gratuit/free for next session

No certificate will be awarded to a student unless he/she passes the qualifying DELF/DALF exams. If French is to be studied at AFD after at least six months break, a placement test is compulsory for one to start at AFD. In any case, the teachers opinion shall prevail to determine testees right level of French.

I have read and understood the above-mentioned Rules and Disciplines and I will abide by it.

Signature of the Student ______________________________________

Date ____-____-________

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For Office Use Only

Admission Previous Result (Applicable to old students) Submission of Photograph Date of Registration
D

New

Old

Cash / Check

Check No

Yes
D M M

No
Y Y Y Y

Signature of the Authorized Personnel ---------------------------

Record of Payments for

Date

Account Use Only

Text Books Accessories Total Amount in BDT Note (If by Check)/Signature

Course Fees

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