Application for a place in Session(s) n.., starting on (dd/mm/yyyy) /. /20

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1 Form 1 «Registration» RELIGIOUS NAME:.. DATE OF BIRTH:... PLACE OF BIRTH:... NATIONALITY:... PASSPORT N :... EXPIRY DATE: (dd/mm/yyyy) /../... PRIEST RELIGIOUS LAY PERSON MARRIED ADDRESS:... TOWN/CITY:... POSTCODE:... COUNTRY:... PERSONAL DETAILS OF THE REFEREE: RELIGIOUS NAME:.. ADDRESS:... TOWN/CITY:... POSTCODE:... COUNTRY:... DETAILS OF THE APPLICATION: Application for a place in Session(s) n.., starting on (dd/mm/yyyy) /. /20 METHOD OF PAYMENT: To whom should the statement be addressed? The referee Or other (name& address)... VISA: If the applicant must obtain a visa to attend the course, do you require an invitation letter from us? No Yes If yes, please complete Form 3 «Visa». TERMS OF PAYMENT: Payment of a non-refundable deposit of 300 Euros ( ) will be required once the application is accepted. Payment of the balance due for each session must be made 20 days before the start of the session. Once a student has begun a session, full payment is expected. Payments should be made in Euros ( ) by international bank transfer. Foreign cheques cannot be accepted. The applicant and the referee agree to the conditions stated. Signature of the applicant Signature of the referee.. Date (dd/mm/yyyy).. /.. /20.. Date (dd/mm/yyyy) / /20

2 Form 2 «Educational Information» FAMILY NAME:... FIRST NAME:... RELIGIOUS NAME:.. DATE OF BIRTH:... NATIONALITY:... PRIEST RELIGIOUS LAY PERSON MARRIED PHONE: USEFUL INFORMATION : MOTHER TONGUE:... OTHER LANGUAGES SPOKEN:... MAIN AREA OF COMPLETED STUDIES:... MAIN PAST ACTIVITIES:... PRESENT OCCUPATION:... HAVE YOU STUDIED FRENCH BEFORE? YES NO IF SO, WHEN?... W?... FOR HOW LONG?...( HOUR(S)/MONTH OR.HOUR(S)/WEEK) HOW WOULD YOU RATE YOUR LEVEL OF FRENCH? WRITTEN: NIL WEAK MEDIUM GOOD ORAL: NIL WEAK MEDIUM GOOD PROJECT FOR WHICH FRENCH IS REQUIRED: MISSION «AD GENTES» PROJECT PASTORAL PROJECT STUDIES/FORMATION RESPONSABILITIES WITHIN YOUR INSTITUTION OTHERS DESCRIPTION OF THE PROJECT: TO ALLOW US TO MAKE A PRELIMINARY EVALUATION: IN TEN LINES, PLEASE RECOUNT IN FRENCH SOMETHING YOU REMEMBER FROM YOUR HOLIDAYS OR CHILDHOOD (DON T USE A DICTIONARY, A GRAMMAR BOOK, OR ANY OTHER OUTSIDE HELP!):

3 Form 3 - «Visa» To be completed only if the applicant needs an invitation letter to apply for a visa to stay in France. Please also attach a copy of the identity page of the applicant s passport. DATE AND PLACE OF BIRTH (dd/mm/yyyy):... NATIONALITY:... PASSPORT N :... ISSUED ON (dd/mm/yyyy): / /20.. AT... EXPIRY DATE (dd/mm/yyyy): / /20 PRIEST RELIGIOUS LAY PERSON FOR RELIGIOUS INSTITUTES: FOR DIOCESES: DATE OF FIRST PROFESSION (dd/mm/yyyy):../../. DATE OF PERPETUAL PROFESSION (dd/mm/yyyy):../../... NOVICE POSTULANT DATE OF ORDINATION: (dd/mm/yyyy):.../.../. DATE OF INCARDINATION: (dd/mm/yyyy):.../.../. BISHOP PRIEST SEMINARIAN OTHER (SPECIFY):.. MEDICAL INSURANCE COMPULSORY: NAME OF THE INSURANCE COMPANY THAT WILL COVER THE APPLICANT DURING THE FIRST THREE MONTHS IN : I.M.S. (INTERNATIONAL MISSIONARY BENEFIT SOCIETY) CAVIMAC («CAISSE DES CULTES») OTHER (SPECIFY) :... PERIOD COVERED FROM (dd/mm/yyyy).. /.. /. TO (dd/mm/yyyy).. /.. /.. ARRIVAL DATE IN : (dd/mm/yyyy).. /.. /.. PERSONAL DETAILS OF THE REFEREE FOR THE APPLICANT: RELIGIOUS NAME:.. ADDRESS:... TOWN/CITY:... POSTCODE:... COUNTRY:... The referee for the applicant s formation certifies that the above information is correct. Signature of referee.. Date (dd/mm/yyyy) / /20.. Stamp or seal of the Institution

4 Application for Financial Assistance Form 4 - «Scholarship» TO BE COMPLETED BY THE REFEREE FOR THE APPLICANT. If you believe your institution does not have sufficient resources to cover the costs entirely, you can apply for a scholarship from the Pontifical Mission Societies with whom Mission-Langues works in close collaboration. This request is reserved exclusively for mission ad Gentes projects. To present your request, would you please fill in this form in full detail and return it to us. On behalf of my organisation, I humbly request from the Pontifical Mission Societies a scholarship to allow one of our members to undertake a course at Mission-Langues: RELIGIOUS NAME:.. DATE OF BIRTH:... PLACE OF BIRTH:... PRIEST RELIGIOUS LAY PERSON NATIONALITY:... ADDRESS:... TOWN/CITY:... POSTCODE:... COUNTRY:... PERSONAL DETAILS OF THE REFEREE: RELIGIOUS NAME:.. ADDRESS:... TOWN/CITY:... POSTCODE:... COUNTRY:... DETAILED DESCRIPTION OF THE MISSIONARY PROJECT OF THE APPLICANT: PLACE OF MISSION, ROLE IN TYPE OF MISSION (EX: FIRST EVANGELIZATION, PASTORAL ACTIVITIES, CATECHESIS, SPIRITUAL ANIMATION ), THE MISSIONARY COMMUNITY:

5 REASONS FOR THE REQUEST (IN DETAIL): HAVE YOU APPROACHED OTHER BENEFACTORS FOR ASSISTANCE? WOULD OTHER PROVINCES OF YOUR INSTITUTION BE ABLE TO PROVIDE FINANCIAL SUPPORT? ARE THE PONTIFICAL MISSION SOCIETIES YOUR LAST POSSIBLE RESORT? REQUEST FOR ASSISTANCE: Our request is for a scholarship amounting to. % of the financial participation. COULD YOU TELL US MORE ABOUT THE MISSION OF YOUR CONGREGATION (COUNTRIES, TYPE OF MISSIONS, OTHER USEFUL INFORMATION)? Although Mission-Langues is committed to forwarding requests to funding authorities, it cannot be held in any way answerable for the responses which might be given. If the request is accepted, the scholarship will be paid directly to Mission-Langues. In case of cancellation of the application, the scholarship will be returned to P.M.S. I, the referee, declare that I understand and accept all the conditions stated and above. Signature. Date (dd/mm/yyyy)./../ Stamp or seal of the Institution