First
Name (s)
Family
/ Surname
Address
Town
or City
Post code / Code Postal
Country
Your
email address
Telephone
Number
Portable
or Mobile telephone Number
Nationality
Age
and Date of Birth
Sex
Male
Female
Describe
what you are
presently doing ?
i.e are you at University and what are you studying?
or are
you working and if so what is your job?
or are you unemployed. Is this part of your gap year or year out? Are
you retired ?
Do
you hold a full driving license ?
Yes
No
Did
you send us your CV ?
Yes
No
Briefly,
What do you expect to learn or
gain from helping us at La Giraudiere ?
You do not have
to be a skilled builder or a computer wizard just a willingness to try
and learn
Briefly,
What skills or qualities do you
think you could give to La Giraudiere or pass on to the rest of the
group ?
If you are a
qualified electricain, English teacher
or maybe a marketing expert would you be prepared to pass on your
skills to others in the group ?
The
Address you will be travelling from if it is different from the above.
i.e. If you are a student what is your university?
Describe
how you will be travelling ?
(We ask this to insure that you have researched how you will arrive at
La Giraudiere and budgeted for your travelling costs)
If
you were ill or had
an accident whilst staying at La Giraudiere who would we contact?
Please supply telephone number with the contact information
What
medical and hospital insurance cover will you have? (Please state the
insurance company you will be insuring with)
What
Languages do you speak ?
Please
Tick how you would like to help.
You can
Tick one or all which you feel you would like to do, learn about or get
involved with
Building and or Restoration
work
Painting, renovation, Property maintenance
Computer,
Marketing, Clerical day to day; blog entries and social media updates
House Keeping,Cooking,Shopping etc
Website
Production,Design,layout,maintenance,improvements etc
Writing, articles for the website about France or the atractions
of France
Research, writing and producing webpages about the nature and (or)
HIstory
Photography, videos and or filming
Will
you require a reciept for your booking in order to help with your
Travel Visa application
Remember
that some
nationals are not allowed to visit France without a permit or
and visa but you
are allowed to visit as a paying guest or a tourist with a confirmed
accommodation reservation.
Please
click the box to confirm yes you do require
How many weeks would
you like to stay at La
Giraudiere ? (Minimum is 3)
Please
indicate which period or periods you would like to be considered for.
March
2012 or
prior
April
2012
May 2012
June 2012
July 2012
August 2012
September
2012
October 2012
You
can check the program dates and what places remaining at ~
PROGRAM
ARRIVAL AND DEPARTURE
DATES
Your
prefered Arrival
Date
Day
---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
-----
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2012
2013
Your
prefered Departure
Date
Day
---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
-----
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2012
2013
Pick
you up where?
Chalais
Gare (Station)
I will arrive
direct at La Giraudiere and will not need picking up
I have my own car / Transport and will arrive direct
If
you
cannot make the trip or you are delayed you should notify us as soon as
possible. No prior cancellation then No refund.
Each
applicant will have
their own room unless you wish to share with a partner or friend.
Please indicate here if you are applying jointly and the name of the
joint applicant. Please note a reduction in the weekly price will be
made for those sharing.