PERSONAL INFORMATION
Full Name:
Contact Email: (required)
Gender Male Female
Age
MAILING/ PERMANENT ADDRESS
Address:
City: State:
Zip Code:
Country:
Telephone: Fax:
PROGRAM
Select the Program: Intensive Spanish Program Intensive Spanish Executive Program Intensive Spanish Semester Program Intensive Spanish Quarter Program Intensive Spanish High School Program Internships Intensive Spanish for Health Program Intensive Spanish for Teachers Program Continuing Education Credits for Nurses Intensive Advanced Spanish for Diplomats Intensive Spanish for Travel Agencies
Date starting classes
Month: Day: Year:
Anticipated period of study: Weeks
Please plan to attend the Orientation and Placement 10 am the previous Saturday or you will miss instruction time on Monday .
HOUSING Please select the plan you prefer: Furnished apartment Host family Plan AA (30.00 U.S.) Host family Plan A (22.00 U.S.) Host family Plan B (17.00 U.S.) Student Residence (25.00 U.S. to 35.00 U.S.) Not Interested
Housing Date: PLEASE NOTE: We strongly recommend that students attend the Saturday Orientation which means that your arrival date will be a few days before classes begin. Month: Day: Year:
Smoking? Yes No Allergies: None Cats Dogs Birds Food
Diet restrictions: Name and address of person to contact in emergency:
Furnished apartment see APARTMENT RENTALS IN CUERNAVACA, MORELOS, MEXICO
TRANSPORTATION Do you need transportation from the airport? (70.00 U.S) Yes No
Flight Information: (If available)
Port of Departure:
Arrival Date and Time:
Airline / Flight Number:
NOTE : If flight information is not available make sure you send us your complete flight information as soon as possible at jimhorn@educationaltravel.com.mx OTHER COMMENTS:
Registration Form
