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| PERSONAL INFORMATION |
| Name: |
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| Last name: |
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| Gender: |
Male Female |
| Age: |
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| Occupation: |
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| Email address: |
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| 2nd email address: |
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| Address: |
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| City: |
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| State: Zip code: |
| Country: |
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| Phone (Code - Number): |
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| Fax (Optinal) (Code - Number): |
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| COURSE |
| Select the program: |
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| Arrival date: Time of Arrival: |
| Date to begin class: Length of study (# weeks): |
You are coming as:
Independent
Part of a group
If so, name of the leader of the group: |
Do you have previous Spanish experience? Please describe
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| Level: |
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Are you a returning student? Please let us know previous date of attendance:
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| Why do you want to learn Spanish? |
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| Do you need college credit?: |
Yes No |
| Name of home institution: |
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| LODGING |
| Host Family Hotel assistance Not required |
| Date to begin housing: Departure date: |
| Do you smoke?: |
Yes No |
| Diet restrictions: |
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| Allergies: |
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| Is private airport pick up service needed?: Yes No |
| If yes, please provide the arriving flight information, if known: |
| Airline : Flight number: |
| Last airport of departure to Mexico City: |
| Kind of desired transport: |
Midsize car Van |
If flight information is not available yet,
send it as soon as possible to schedule your pick up service at:
admissions@spanish-school-aztlan.com |
| OPTIONAL INFORMATION |
| Name and address of your institution or organization |
| Name: |
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| Address: |
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| City: |
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| State: Zip code: |
| Country: |
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| Phone (Code - Number): |
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How did you learn about us?: (Who referred you; which search engine you used
Expo, magazine ad, etc.
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| Other comments: |
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| Promotion code: |
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