| Surname: |
________________________________________ |
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| Christian Name: |
________________________________________ |
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| Fathers or Mothers: |
________________________________________ |
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| Date Of Birth: |
________________________________________ |
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| Height: |
________________________________________ |
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| Address: |
________________________________________ |
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________________________________________ |
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________________________________________ |
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________________________________________ |
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| Home Phone: |
________________________________________ |
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| Email: |
________________________________________ |
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| School: |
________________________________________ |
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| Name Of French Teacher: |
________________________________________ |
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| No of yrs of French(up until June 12): |
________________________________________ |
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| Father's/Mother's Occuption: |
________________________________________ |
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| Number Of Brothers? |
____________ Ages __________ |
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| Number Of Sisters? |
____________ Ages __________ |
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| Where does your family live? |
________________________________________ |
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| Please tick the appropriate: |
Town() Village() City() Suburbs() Farm() |
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| Interest & Hobbies: |
________________________________________ |
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| Type of Character? |
Shy()
Outgoing()
Confident()
EasyGoing()
Determined() |
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| Group Preferring? |
Group I() Group II() April/May Group() |
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| Type of family preferring in France? |
Town() City() |
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| Type of partner preferring in France? |
________________________________________ |
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Health Problems
(If Any)? |
________________________________________ |
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| Other Comments |
________________________________________ |
