Accueil-Jeunes – Visit request form

To fill in the form :
* Check availability by consulting the calendar
* Enter your complete application below. It will be pre-registered and you will automatically receive an email summary.
Thank you to wait then our response will be sent by email within two weeks.

Informations on the establishment

Name of the establishment *
Address 1 *
Address 2
Postal code *
City *
Country *
Phone number *

Informations on the group

Caution, your group has a high number of people. It may take two visits to allocate slots. We will contact you about this.

Level *
Number of pupils *
Number of adults *

Main responsible for the group

Title *	Mrs Miss Mr
First Name *
Last Name *
Mobile phone (available on the day of the visit) *

Informations on the visit

Desired date *
Desired hours *	Avez-vous bien vérifié la disponibilité du créneau demandé dans le calendrier ? 9:45 – 10:45 am 11:00 – 12:00 am 2:00 – 3:00 pm 3:15 – 4:15 pm No preference
Additional Information - Special Requests
Email address for the response *
Email (confirmation) *