DELF/DALF tout public Session: November 2019 Alliance Française de la Région de la capitale nationale du Canada 352, rue MacLaren, Ottawa, Ontario, K2P 0M6 | Tél. 613-234-9470 | www.af.ca/ottawa Family name: ____________________________________________ Given name: _______________________________________________ Sex Male Female Other Date of birth: ___________________________[YYYY/MM/DD] Country of birth: _______________________________________ City of birth: _______________________________________________ Citizenship: ______________________________________________ Native language: _________________________________________ Address: _________________________________________________________________________________________________________________________ Street Apt. # City ____________________________________________________________________________________________________________________________________ Province Postal code Country Phone: ___________________________________________________ Email: _______________________________________________________ Have you registered for the DELF before? No Yes, candidate number: ______________________________ Select the test or tests for which you would like to register (you may choose more than one): Diploma s Levels DELF-DALF tout public Fees DELF A1 Basic A1 (November 4) $125.00 DELF A2 A2 (November 5) $125.00 DELF B1 Independant B1 (November 6) $195.00 DELF B2 B2 ( November 7) $195.00 DALF C1 Proficient C1 sciences (November 8) C1 lettres et sciences humaines (November 8) $275.00 DALF C2 C2 sciences (November 4) C2 lettres et sciences humaines (November 4) $275.00 TOTAL : $__________
Transcript
DELF/DALF tout public
Session: November 2019
Alliance Française de la Région de la capitale nationale du Canada
Family name: ____________________________________________ Given name: _______________________________________________
Sex Male Female Other Date of birth: ___________________________[YYYY/MM/DD]
Country of birth: _______________________________________ City of birth: _______________________________________________ Citizenship: ______________________________________________ Native language: _________________________________________
Address: _________________________________________________________________________________________________________________________ Street Apt. # City ____________________________________________________________________________________________________________________________________ Province Postal code Country Phone: ___________________________________________________ Email: _______________________________________________________ Have you registered for the DELF before? No Yes, candidate number: ______________________________
Select the test or tests for which you would like to register (you may choose more than one):
ACCEPTANCE OF GENERAL CONDITIONS 2019-2020 These general sales conditions govern all of the relationship between the Alliance Française Ottawa (AFO) and its clients/students with respect to enrolments and organisation of courses/exams, except in the case of express, written derogation. By placing an order and/or enrolling, the client accepts these general conditions. These conditions shall apply exclusively from the enrolment of the client and/or the student. TESTS AND CERTIFICATIONS All applications must be received before the registration deadline (see calendar). No application will be
accepted if received after the registration deadline. No exceptions will be made. A non-refundable $75.00 fee will be charged in the event of cancellation or rescheduling before the
registration deadline. No refund or change of test date will be accepted if received after the registration deadline. It is the sole responsibility of the candidate to ensure that he/she is registered for the appropriate exam. The
Alliance Française Ottawa and its employees cannot be held responsible for the choices made by the candidate.
Payment must be made in full at the time of registration. No refund or credit will be granted under any circumstances past the aforementioned deadlines, unless the
Alliance Française Ottawa has to cancel a session of tests, in which case an alternative exam date will be offered, or a full refund will be granted.
Validity
These conditions are valid for the fiscal year in court unless they are notified with customer notification.
SIGNATURE:
Date: ___________________
ADMINISTRATION: Date d’inscription: _______________________
AUTORISATION DE PRELEVEMENT – CARTE DE CREDIT PAYMENT AUTHORIZATION FORM – CREDIT CARD
Je, (NOM & Prénom) ____________________________________________________, autorise l’Alliance I, (NAME & first name) authorize Alliance
Française Ottawa (Alliance Française de la Région de la Capitale Nationale du Canada) à Française Ottawa (Alliance Française of the National Capital Region of Canada) to
prélever la somme suivante de ma carte de crédit/débit (références ci-dessous) : collect the following amount from my credit/debit card (references below):
NOM et Prénom de l’étudiant (e): ___________________________________________ NAME and first name of student
Titulaire de la carte (Cardholder) :
Nom (Family name): ___________________________ Prénom (Given name):________________________
Numéro de téléphone (Phone) : _________________ Courriel (Email): _____________________________ Adresse de facturation de la carte (Billing Address):
