Baylor in Paris
May 31 – June 30, 2017
Please enroll me in the Baylor in Paris Summer Program. Enclosed is a deposit check in the
amount of $300 payable to “Baylor in Paris.” Please return to Dr. Bratu in Old Main 375 or
Draper 158.04 or to Dr. Thiltges in Draper 156.06
Full Name _________________________________________ Date ________________________
Student ID # __________________Sex (M or F) _______ Birth Date_____________________
Permanent Address _____________________________________________________________
City ________________________ State _________________ ZIP _______ Phone __________
Present Address ________________________________________________________________
Present Phone _______________________ E-mail Address _____________________________
University currently attending ________________________ Citizenship __________________
Major(s) ____________________________
Minor___________________________________
Year: ( ) Freshman ( ) Sophomore ( ) Junior ( ) Senior ( ) Other: ______________
Current level of French: ( ) 1st year
( ) 2nd year
( ) Advanced
French course you will take /are taking in Spring 2017 (required)____________________________
Courses you will take in Paris:
( ) FRE 2310: Intermediate French
( ) FRE 2320: Intermediate French
( ) FRE 3320: Conversation and Composition
( ) FRE 3348: Paris and Its Culture
Person to notify in case of emergency:
Name ___________________________________________ Relationship __________________
Address ______________________________________________________________________
City ________________________ State ______________Zip______ Phone ______________
Do you plan to travel to France with the Baylor group? _________ If not, indicate travel plans:
_____________________________________________________________________________
How did you learn about this program? _____________________________________________
Reason for interest in the program: _________________________________________________
______________________________________________________________________________
Note: Enrollment is limited. A place in the program will not be secured without a $300 deposit.
I have read the program brochure and agree to abide by all conditions specified in this text. I further agree to abide
by the laws and regulations of France and the decisions of the directors during the course of the program.
Signature __________________________________________ Date ______________________
Baylor in Paris office: Deposit _____ Balance _____