Name: * (LAST, First, Middle) Program Information Desired class size: * Individual Group class(2-6 students) Classes are offered Monday through Friday, for 4 hours a day The cost of a group class is CFA 8000/per student Registration fees and welcome pack: CFA 17.500 Placement Test: CFA 6000 French Exercise Book: CFA 21.000 per student & per level Student's Wolof Book: CFA 3.000 per Unit (there are 3 Units in total) Desired Starting Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202520262027 Language Requested: * - Select -WolofFrenchPuulaarMandinka Level: * - Select -BeginnerIntermediateAdvanced Total Number of Hours: * Please, don't put any space between the digits! Spoken Languages: * Proposed Schedule: Planned Date of Arrival to Senegal: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024202520262027 Homestay Homestay Desired?: * Yes No Homestay Duration: 2 weeks 4 weeks 6 weeks 8 weeks Would you prefer to be placed with another student or by yourself ?: Do you smoke ?: No Yes Can you live with smokers ?: No Yes Food or dietary restrictions, if any: Please briefly describe yourself and your own family: Airport Pickup Arrival: Yes No Departure: Yes No Personal Information Birthdate: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010 Gender: * - Select -MaleFemale Nationality: * Email: * Confirm email: * Phone: * Please, don't put any space between the digits! Address: * Office/University: Profession/Title: How I learned about the Baobab Center How I learned about the Baobab Center: CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
