2005 Course Application Form (required fields are shown in red)
 
I read and agree  to the Terms and Conditions
 
First Name:
  Last Name:  
  Address: (number + street)
  (City)
  (State)
  (ZIP code)
     
  Country of Origin:
  Date of Birth: (MM/DD/YYYY)
  Passport#:
  E-mail address:  
  Phone:  
     
  Spanish Level  
 
(as per your own evaluation)		 Higher Elementary
  Intermediate
  Higher Intermediate
  Advanced
 
The Schedule:
The students can opt to travel to Buenos Aires on Mid April, or end of November.  Specific travel dates will be announced later to better accomodate the students groups.  Mid April 2005
November 2005
Accommodation Application:
Please specify a package option
(see the FEES section for Package Description and Cost)		 #1
#2
#3
#4
#5
#6
  If you selected Options #1 or #2 (that is, if you selected to stay with a family) please complte the following:
  Do you smoke? No  Yes
  Does it bother you if any of the family members smoke?  No  Yes
     
  In all our homes you are free to prepare your own meals, however, some families offer to cook for you for an additional fee:
  Are you a vegetarian? No  Yes
 

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