Maison Ursulines Registration Form

1
Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Aruba
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Austria
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The Bahamas
Bahrain
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Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
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Colombia
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Cote d'Ivoire
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Cuba
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Democratic Republic of the Congo
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Falkland Islands
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France
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Iran
Iraq
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Israel
Italy
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Japan
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Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
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Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Samoa
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eSwatini
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Taiwan
Tajikistan
Tanzania
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Togo
Tokelau
Tonga
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Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
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Other
Country
3
Phone Number
Please enter a valid phone number.
4
Email* This field is required.
example@example.com
5
Requested Check-in Date* This field is required.
Date
Month
Day
Year
6
Requested Check-out Date* This field is required.
Date
Month
Day
Year
7
Shuttle Service Needed* This field is required.From and to YQB Airport
Yes
No
8
Shuttle Service Pick-up Time
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
AM
AM
PM
9
Any Additional Comments / Notes
10
Dear Family Member, Friend or Business Associate,

Thank you for choosing to stay at la Maison Ursulines during your visit to Quebec City. Cindy and I are looking forward to your enjoying the apartment, and the surrounding Old Quebec neighborhood.

If I can help in any way, please don't hesitate to reach out.

Best, Paul
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