APPLICATION FORM ALLIANCE SUMMER PROGRAMS 2018 APPLICATION FORM ALLIANCE SUMMER PROGRAM 2018

APPLICATION FORM ALLIANCE SUMMER PROGRAMS MAY 2 ND – AUGUST 3 RD 2018 TUITON FEES PAYMENT I the undersign (first name – last name):_______________________________ FEBRUARY _ 19TH, 2018 Institution Member: ________________________________________________ THE LATEST Pay the tuition fees for the Alliance Summer Program 2018  By credit card  Visa  MasterCard / Eurocard  American Express N°…………………………………………………………………… Expiration date Key Charging date …………/…………../………….. ………… …………/…………../…………..  I chose Culinary Arts Program and I authorize Institut Paul Bocuse to charge my credit card for an amount of 5710 €uros (five thousand seven hundred & ten €uros).  I chose Hospitality and Food Service Program and I authorize Institut Paul Bocuse to charge my credit card for an amount of 6000 €uros (six thousand €uros).  By bank transfer To INSTITUT PAUL BOCUSE INNOVATION & DEVELOPPEMENT Banque BNP PARIBAS : LYON METROPOLE ENTREPRISES (02249)  Code 30004 02249 00011270621 84 Numéro de compte bancaire international – IBAN  FR76 3000 4022 4900 0112 7062 184 Code d’Identification bancaire – BIC  BNPAFRPPLPD Thank you to specify the candidate full name on the bank transfer. Date & Signature :

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