Middle Name
Last Name
Street Address 1
Street Address 2
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business address?
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Home
Business
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
Have you studied Spanish?
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
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year
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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:
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Restrictions or allergies to food or
animals
Bothered by cigarette
smoke?
Interests and hobbies
FLIGHT INFORMATION
Airline
Flight No
Date of arrival
day
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Time of arrival
Hour
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Minutes AM/PM
00 AM
15 AM
30 AM
45 AM
00 PM
15 PM
30 PM
45 PM
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:
self
company
academic institution
representative
travel agency
other - fill out box
Other:
