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Spanish language school with home stays in Costa Rica registration form of spanish immersion programs
Registration Form
PERSONAL INFORMATION
Name: (required)
Last Name: (required)
Occupation:
Company:
Place of birth:
Date of birth: (month/day/year)
Sex:
Address:
Work Phone:
Home Phone:
Fax:
Email: (required)
What languages do you speak?
Have you received Spanish classes before?
If yes, where?
For how long?
In what level of Spanish do you consider to be at this moment?
How did you hear about the C.R.L.A.?
Former Student
Internet
Magazine/Book
Other Source
ENROLMENT
Program you are enrolling for:
Number of weeks:
Type of classes:
Hours per day:
Days per week:
With homestay:
Dates you will be at the academy?
From: (month/day/year)
To: (month/day/year)
Do you want to be picked up at the airport?
Date: (month/day/year)
Time: : (hour : minute)
Airline:
Flight #:
HOMESTAY INFORMATION
What type of lodging do you prefer:
Room:
Atmosphere:
 
Children:
Pets:
Other Preferences:
Do you have allergies or other relevant health problems? (Specify)

NOTE: The information provided will be used to make the best possible match between the student and the family, although we try to meet as many of the student's desires, we do not require that the family or the Academy provide everything that the student has checked off.
What do you hope to gain from this experience?
Date: (month/day/year)
PERSON TO NOTIFY IN CASE OF EMERGENCY
Name & relation to student:
Address:
Home Phone:
Work Phone:

or  


Phone (305) 359 5256, Fax (506) 233 5284.
E-mail [email protected]
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