<p> ACCOMMODATION FORM FOR INTERNATIONAL STUDENTS</p><p>Mr. Ms. First name: Family name: </p><p>Nationality Date of birth (dd/mm/yyyy): </p><p>Tel (include country code): email: </p><p>Start date (dd/mm/yyyy) End date: (dd/mm/yyyy) </p><p>The accommodation service undertakes the accommodation process once the student has paid the 200€ accommodation down payment and the 70€ accommodation Booking. “First paid, first served”. When your accommodation is validated, no change will be possible.</p><p>AUTUMN SEMESTER: Booking before 15th June. We request payment of 50% of your entire stay before the 15th of August and the remaining amount on the first week of your stay. If you do not pay within the first week, the access to your room will be blocked. </p><p>SPRING SEMESTER: Booking before 15th November. We request payment of 50% of your entire stay before the 15th of December and the remaining amount on the first week of your stay. If you do not pay within the first week, the access to your room will blocked.</p><p>COST: - Accommodation Booking: (not refundable) ------70€ - Accommodation Booking down payment: (not refundable) ------200€ The down payment will be deduced from your first month payment. - Rent: per calendar month------600€ Residence Comfort Suites: Studio of about 18m² with a sofa-bed, a desk, an LCD-TV, a table. Individual small kitchen equipped with microwave, heater, fridge and dishes. Individual bathroom with toilets, shower. Cleaning kit, towels, bed linen and blanquet included. Internet and electricity included. Extra taxes could be charged at the end of your stay in case of over-consumption (water, electricity). Each started month is due. - Security Deposit to be paid on arrival at Residence Comfort Suite: ------500€ To be paid back to you within 2 months after departure if no damage. Damaged items, electricity or water over consumption cost will be deduced. - Compulsory Departure cleaning to be paid on arrival: ------70€ </p><p>I want to book accommodation with IPAC accommodation service at Residence Comfort Suites (600€ per month - www.comfortsuites-annecyseynod.com) I agree to pay the deposit of 270€ in order to book accommodation I agree to pay security deposit and departure cleaning on arrival at the residence. I authorize the debit of 270€ (see international credit card debit authorization on this form)</p><p>For any further information, payment, or problem regarding accommodation please contact the accommodation service: Véronique TiIlier: [email protected] +334 50 45 80 27 PAIEMENT AUTHORIZATION :</p><p>I, , hereby authorise, IPAC, to charge the following fees to my credit card :</p><p>Charged Amount : € </p><p>Card Type : □ Visa □ American Express □ Mastercard</p><p>CARTE CREDIT N° |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| </p><p>Date : |__|__| |__|__| </p><p>Security number |__|__|__|</p><p>______Card Holder’s name and signature Date</p><p>AUTORISATION DE DÉBIT:</p><p>Je soussigné(e), , autorise la société IPAC, a débiter le montant suivant :</p><p>Montant à débiter : € </p><p>Type de Carte : □ Visa □ American Express □ Mastercard</p><p>CARTE CREDIT N° |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__|</p><p>Date d’expiration : |__|__| |__|__| </p><p>N° de sécurité |__|__|__|</p><p>______Nom du titulaire de la carte et signature Date</p>