FAMILY ACCOMODATION

APPLICATION FORM FOR ACCOMODATION WITH A HOST FAMILY
Name:
 Surname:
Profession: Age:

Address:

City: State/Province:

Country:

 Postal Code:

Email:

 Contact Telephone:
ID / Passport nº:
*Please do not leave any blanks between numbers and letters. (e.g.: 00000000F)
Sex:


Centre of Origin:

Address:

State / Province:

City:

Postal Code:

Country:

Contact Telephone:

Fax:

Email:

Activities at CSLM:

Enrolled in: (specify course name, level and code)

Accomodation time cannot last longer than the course
Beginning of stay:

End of stay:

VERY IMPORTANT: Read ACCOMODATION RULES
NOTICE: This application will not be processed until payment of registration