REGISTRATION

 
1. Personal Information

Family Name :

First Name :
Sex:
Date of Birth dd/mm/yy

Nº Passport :

e-mail :
Country
Profesion or course of studies
I think my spanish level is

 

2. Information

Have you studied Spanish before? Yes No
Where did you study Spanish?
Where did you find out about “Acento Latino”?  

 

3. Registration

  

Survival Course
Basic Course
Intermediate Course
Advanced Course
Superior Course
Technical Course

  
Course Date    
From : To:
dd/mm/yy dd/mm/yy
(*) I will need airport pickup at $10.00 (USD) Yes No
(*) I will need bus station pickup at $3.00 (USD) Yes No
(*) Write to us about details (ex. Arrival time, Airline, # Flight, etc.): information@acentolatino.org

 

4. Contact Information Abroad

Name
Relationship Telephone(with code)
City Province/State Country

 

5. Contact Information in Arequipa

Name    
Telephone Address