Application FormInternational Pen Friends (IPF)Student ServiceForm S100E
Section S1Please Write Clearly
Full Name of Teacher (or person in charge):School Class , Reference or Grade:
Name of School:
School Address: / Street:
Suburb/Town
State:
Post/Zip Code: / For Office Use Only:
Country:
Teacher’s E-mail: / 3748
IPF Agent 3748
Do your students require male or female correspondents, or both? Male Female Both
How or where did you learn about our Club?Tick whichever items are of general interest to your students:
IPF Agent 3748
Animals
Antiques
Art
Astrology
Camping
Cars
Chess
Computer
Cooking
Crafts
Dancing
Environment
Exchange holidays
Farming
Fashion
Fishing
Gardening
Genealogy
Health & Fitness
History
Internet
Languages
Literature
Movies
Music
Philately
Philosophy
Photography
Reading
Religion
Science
Social Work
Sport
Theatre
Travel
Writing
IPF Agent 3748
Tick any items you would be interested in exchanging:Cards Stamps Souvenirs Dolls Books CDs
Please tick AT LEAST 8 DIFFERENT COUNTRIES in which you would like to have pen friends. We always try to match country request, but if there are request we cannot meet, we will provide you with pen friends from other countries.
Africa:
Algeria Angola Kenya Uganda Egypt South Africa Africa General Indian OceanIslands General
The Americas:
Argentina Brazil Canada Caribbean Columbia Mexico Peru USA South/Central America General
Asia/Pacific:
AustraliaIndonesiaKoreaNew ZealandChinaTaiwanAsia-General
IndiaJapanMalaysiaPhilippinesSingaporeThailandPacificIslands General
Western Europe:
AustriaDenmarkFinlandGreeceIcelandItalyNorwaySpainSwitzerlandScotlandWesternEuropeGeneral
BelgiumFranceGermanyHollandIrelandMaltaPortugalSwedenEnglandWales
Eastern Europe:
AlbaniaCroatiaEstoniaLatviaPolandCISSlovakiaEastern Europe General
BulgariaCzechRepublicHungaryLithuaniaRomaniaRussiaUkraine
Middle East:
IsraelSaudi ArabiaIranTurkeyMiddle East General
Special Notes: It should be understood that although we have student members in many countries, they may not all be able to correspond in your language. For example, a very young Danish student may not be able to correspond in English. We always try to match country requests, but there may also be other countries on the pen friend lists.
THIS SHEET MUST BE COMPLETED AND RETURNED TO US WITH THE 700E SHEETS.
Service FeesUS$CAN$ EuroUK£
S1 Service: For 10 students aged from 10-17 ...... $55...$55...€40.£35
S2 Service: For 20 students aged from 10-17 ...... $110..$110..€80.£70
S3 Service: For 30 students aged from 10-17 ...... $165..$165..€120£105
M1 Service: Subscription for 4 issues of Club Magazine...... $35...$35...€25.£20
M2 Service: Subscription for 1 issue of Club Magazine...... $12...$12...€10.£8
B1 Service: Booklet on Letter Writing and Pen Friend Hints....$6....$6...€5..£5
Please complete: Total of Students: / Magazine Subscription (M1 ou M2): / Total Number of Booklets Required:Please Note: To participate in the school service you will need to enrol a minimum of 10 students. You do not have to enrol an exact number of 10, 20 or 30 students, however, please attach the correct service fee per student, based on the rates shown above (US$5.50, or CAN$5.50 or €4 or £3.50 per student). Details relating to each of the students should be TYPED or WRITTEN CLEARLY on the attached sheets.
Please return this form and the 700E Sheet/s with the Service Fee to:
Martine Darroux PicabeaIPF14 rue Marquis de Maubreuil Apt. B34 44470 Carquefou(France)
You can also send this application form by e-mail to:
Total Amount of Payment Attached:Form No 700E – Student Details
Please complete the sections set out hereunder, in respect of each student (aged 10-17 years) and return this list to us. The particulars should be typed (or written clearly). It is particularly important that the correct year of birth is stated in each instance. The home address must always be stated. Any extra details you wish to give can be specified overleaf. (Please do not write with pencil.) We try to match country requests but there may also be other countries on the pen friend lists.
Full Name: / Full Name:Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Form No 700E – Student Details
Please complete the sections set out hereunder, in respect of each student (aged 10-17 years) and return this list to us. The particulars should be typed (or written clearly). It is particularly important that the correct year of birth is stated in each instance. The home address must always be stated. Any extra details you wish to give can be specified overleaf. (Please do not write with pencil.) We try to match country requests but there may also be other countries on the pen friend lists.
Full Name: / Full Name:Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Form No 700E – Student Details
Please complete the sections set out hereunder, in respect of each student (aged 10-17 years) and return this list to us. The particulars should be typed (or written clearly). It is particularly important that the correct year of birth is stated in each instance. The home address must always be stated. Any extra details you wish to give can be specified overleaf. (Please do not write with pencil.) We try to match country requests but there may also be other countries on the pen friend lists.
Full Name: / Full Name:Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
Full Name: / Full Name:
Home Address: / Home Address:
Male or Female: Male Female / Year of Birth: / Male or Female: Male Female / Year of Birth:
Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish / Languages: / English
French / German
Greek / Italian
Portuguese / Russian
Spanish
E-mail: / E-mail:
IPF Agent 3748