IMT-BS et TSP or other Student's

FORM FOLLOWING REQUEST FOR ACCOMMODATION DURING THE SCHOOL YEAR

Civility *
M.Mrs
Surname *

Name *

personal email *

VERY IMPORTANT: We will use this address to communicate essential information to you; You are solely responsible if you ignore them. Make sure you do not block receipt of our emails (spam filter).

Date of birth *

format : dd/mm/yyyy
Nationality *

personal number phone *

Family Adress *

Family Postal Code *

Family Town*

Family Country*


CAUTION INFORMATION
Civility *
M.Mrs
Surname *

Name *

Adress *

Postal Code *

Town *

Country *

personal caution e-mail *

VERY IMPORTANTE : We will use this address to communicate essential information to you; you engage your sole responsibility if you ignore them. Make sure you do not block receipt of our emails (spam filter).
personal caution number phone *


MEMBERSHIP INFORMATION
Your school *
IMT-BSTSPAutres
course followed upon your arrival at MAISEL
1 single checkbox

IMT-BS-1A IMTBS-C1
IMT-BS-2A IMTBS-C2
IMT-BS-3A IMTBS-C3
IMT-BS-BACHELOR-1A IMTBS-BACH1
IMT-BS-BACHELOR-2A IMTBS-BACH2
IMT-BS-BACHELOR-3A IMTBS-BACH3
IMT-BS-STAGIAIRE ou IMT-BS-THESARD IMTBS-STATH

TSP-1A TSP-C1
TSP-2A TSP-C2
TSP-3A TSP-C3
TSP-FISA-1A TSP-FISA1
TSP-FISA-2A TSP-FISA2
TSP-FISA-3A TSP-FISA3
TSP-STAGIAIRE ou TSP-THESARD TSP-STATH

Autres


Your arrival date*

Aamong the opening days and hours of our offices :
Monday to Thursday from 1:30 p.m. to 5:30 p.m. - Friday from 1:30 p.m. to 4:30 p.m.

Attention ! This date cannot be modified, your first fee will be calculated from this date even if you arrive after
format : dd/mm/yyyy
Departure date :

"BANK DETAILS"

Country Code * (exemple : FR)

Country Controle Code* (exemple : France = 76)

Code BBAN * (exemple : establishment code + account + key)

Code BIC *: Insert the 11 characters of your BIC or SWIFT CODE (letters and/or numbers) if less than 11 characters, add XXX at the end to reach 11">

Titular account name

COMMITMENT

*In the event of inaccurate information, admission may be refused; Admission is only effective after signing your membership contract.
I certify on my honor the accuracy of the information communicated and to have read the Operating Charter of MAISEL SudParis.

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