NEW REGISTRATION FORM First Name *Last Name *Phone Number *Email *Date of Birth *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925ARE YOU A STUDENT AT ALLIANCE FRANCAISE DAR-ES-SALAAM? *YESNOType of Class *Please select your optionKids (Under 6 years old) – French General ClassKids (above 6 years old) – French General ClassAdults (Above 18 yrs) – French ClassFrench Private ClassKiswahili General ClassKiswahili Private ClassAdult French Class Category *Enter your categoryRegular A1.1 – Mon/Wed (6pm – 8pm)Regular A1.1 – Tues/Thur (6pm – 8pm)Intensive evening – Monday to Friday (5:30- 8pm)Intensive Morning- Monday to Thursday (9am to 12pm)Semi- intensive Morning – Tuesday and Thursday (9am to 12pm)Private Classes Category *Enter your categoryMINI – 5 HOURSMEDIUM – 10 HOURSMAX – 20 HOURSKiswahili Classes Category *Enter your categoryBeginner – Monday / Wednesday (6pm to 7:30pm)Intermediate – Monday / Wednesday (6pm to 7:30pm)Beginner – AfternoonKids French Class CategorySaturday – 9am to 11amSaturday – 11:30am to 1:30pmHow did you pay ?CashMpesaSelcomCredit Card at the receptionOnline payment through the websiteComment REGISTER Thanks for your registration !