Éducation Permanente
181 Donald Street, Ottawa (Ontario) K1K 1N1
Tel. 613-741-2304 ext. 3; Fax: 613-741-2191
www.educationpermanente.ca
REGISTRATION FORM: FRENCH AS A SECOND LANGUAGE
Contact information:
IN CLASS / ONLINE *
Name: __________________________________
First
Address: _________
Apt. No.
_________
Street No.
__________________________________
Family
_________________________
Street Name
Telephone: (home) ________________________________
(Cell.) _________________________________
Date of birth: (day) ______ (mo.) ______ (yr.) ______
 male
_______________________
City
 female
___________
Postal Code
(work) ____________________________________
E-Mail: ____________________________________
Social Insurance Number: __________________________
Immigration I.D. _______________________________ or Embassy I.D. Number: _____________________________
Immigration Status
Canadian Citizen
Landed Immigrant
Refugee
Country of Birth ____________________________________
Other _________________________________
First language _______________________________
SITES: École Bernard-Grandmaître
Saturday: 9 am to noon
Level

SCHEDULE:
* Courses are offered on different evenings according to the level. Please check our web site www.educationpermanente.ca
for exact schedule.
*
Mac users must install Windows and Internet Explorer in order to use a full version of TMM program.
 Subsidized for immigrants, refugees and new Canadians whose mother tongue is neither French nor English.
 LICENCE NON REFUNDABLE.
 Fees apply for non-subsidized students: English-speaking Canadians, out of province resident, temporary visas.
 A placement test is compulsory for all levels except for level 1.

Signature: _________________________________________________
Date: _____________________________ 
How did you hear about us?  friend  newspaper  brochure  Other _____________________________
For administration use only:
Niveau / session :
Montant payé :
Date :
Mode de paiement :
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
____________________ $__________
___________
$
 Interac
 Visa
 MC
 Amex
FRENCH AS A SECOND LANGUAGE
SCHOOL POLICY
1. Respect of Others



Foul or abusive language is not tolerated towards students, instructors or
administrative staff.
All forms of harassment (verbal, physical or sexual) are strictly forbidden.
All forms of physical or sexual aggression are subject to sanction.
2. Respect of School Property

It is forbidden to export school material off the school premises.
All borrowed material must remain in the classroom.
 No smoking on school property. Smokers must do so on the municipal sidewalk.
 Food and beverages are not permitted in the computer lab.
 All forms of theft and/or vandalism will be immediately dealt with.
3. Attendance





The student must be punctual and respect the class schedule.
The student must inform the instructor when he/she misses a class or will be late.
The program coordinator reserves the right to withdraw any student after 3 absences.
The French as a Second Language course is for adults only.
Only registered students can attend class, no visitors allowed.
4. Reimbursement


Licence cost non refundable
Non subsidized students: Course refundable if student cancels before the 3rd class,
$25 administration fee applies.
I have read and understood the school policies above and wish to engage myself in learning French
as a second language in a professional and friendly manner.
Signature: _____________________________________
Date: _______________________