2 0 0 - 6

APPLICATION  FORM
Name
Gender Male   Famale
Age
Address
e-mail
Telephone
Fax
Level of spanish:      Fair   Basic  Good  Very good  Advanced

In this course
I need to practice my:
Speaking   Understanding
Listening   Reading   Grammar     Writing
To improve my Spanish for: Work  Travel  Study  Pleasure

Description of the course
start date (dd/mm/yy)
Length
Kind of course Regular     Special:economics, business, literature, etc.
Group classes 2 hours a day  4 hours a day             More hours a day (specify)
Tutor classes Hours a day Days per week

LODGING:   I would like to stay in
Host Family (Acces to kitchen) 
Student Residence:                 Half board    Without meals                 Single room   Shared room
Hotel                                   
Arrival date (for Loding)
Departure Date
Do you smoke? Yes      No

Itinerary
Airport transfer? Yes    No
Flight information:
Date
Hour
Airline
Flight number
From