|
Middle Name |
|
|
Last Name |
|
|
Street Address 1 |
|
|
Street Address 2 |
|
|
Is this your home or
business address? |
|
|
City |
|
|
State or Province/Region |
|
|
Country |
|
|
Zip Code |
|
|
Date of Birth |
|
|
Age |
|
|
Sex |
|
|
Nationality |
|
|
Primary Language |
|
|
|
|
Please enter complete
telephone numbers. Please include international country
code, area code, prefixes. |
|
Home Telephone |
|
|
Business Telephone |
|
|
Mobile Telephone |
|
|
Fax |
|
|
E-Mail |
|
|
Occupation |
|
|
EDUCATION |
If you are currently
attending school please provide the following
information
- class level, name of school, course of study |
College, University or School |
|
|
|
|
|
Have you studied Spanish? |
|
Probable Spanish level |
|
|
Reasons for learning
Spanish? |
|
|
How did you hear about
SEC?
If friend or agency
include name of person/agency in box.
If other please specify
in box |
|
|
TYPE OF PROGRAM |
|
Type of Program you wish
to enroll in |
|
Planned Date of
enrollment
classes start on
Mondays |
| day |
|
month |
|
year |
|
|
|
|
|
|
Number of weeks |
|
|
HOUSING |
|
Type of Housing Plan you
wish to enroll in |
|
|
We suggest the students
arrive a few days before beginning classes in order to
attend orientation at the school |
|
Planned date to begin
housing accommodation |
Start:
| day |
|
month |
|
year |
|
|
|
|
|
End:
| day |
|
month |
|
year |
|
|
|
|
Restrictions or allergies to food or
animals |
|
|
Bothered by cigarette
smoke?
|
|
|
Interests and hobbies |
|
|
FLIGHT INFORMATION |
|
Airline |
|
|
Flight No |
|
|
Date of arrival |
| day |
|
month |
|
year |
|
|
|
Time of arrival |
|
|
City of departure |
|
|
TRANSPORTATION |
|
Do you need school to organize your
transportation upon arrival from the airport to the
school? |
|
|
EMERGENCY INFORMATION |
|
In case of emergency,
contact |
|
Name |
|
|
Address |
|
|
Please enter complete
emergency telephone number. Please include international
country code, area code, prefixes. |
|
Telephone |
|
| To enroll,
please complete this form and press the submit button
below. After successful transmission, press continue on
the following page which will take you to our
Payments page and to a link to Cybersource's secure
credit card server. If you prefer to make the payment
via travelers check, please send your $100 USD
counter-signed travelers check and your printed
registration form via certified mail to the mailing
address noted in the menu
Contact Us. If you don't receive a confirmation
within 5 days after sending your registration, please
send us an e-mail or call us to confirm receipt of your
form and your reservation. Additional fees must be paid
in full upon arrival at the school. Tuition can be paid
via cash or credit card, but if you are staying with a
Mexican Host Family, the payment must be made to the
school in cash (US dollars or Mexican Pesos). Please
note that all prices are subject to change. |
Registered by:
Other:
|
|
|
