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| SECTION ONE - Your start date: |
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| Date to begin class:
Length of study:
Hours:
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| Location:
Cuernavaca, south of Mexico City
Tulum, south of Cancun |
| SECTION TWO - About yourself: |
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| Email Address: | |
| Alternate Email: | |
| a second email address for you is helpful |
| Name on Registration: | |
| there is space in Section 3 below for additional student names |
Complete
Mailing
Address: | |
| Primary Phone: | |
| Fax: (optional) | |
| Your Age: Month/Day of birth:
Female Male |
| Complete the following 4 questions for all adults who will be attending: |
| Question 1) Occupation/employer/other: |
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| Question 2) Why do you want to learn Spanish? |
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| Question 3) Interests or hobbies: |
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Question 4) What contact, if any, have you had with the Spanish language? If so, for how long?
Include date of previous attendance at Chac-Mool, if applicable. |
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| SECTION THREE - complete for each additional person coming with you: |
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| Name (student #2):
Age:
Month/Day of birth:
Female
Male
Type of class: Adult
Teen
Junior
Programa Amiguitos
Not Sure
Previous Spanish?
Interests/hobbies?
If child, shy or outgoing?
If child, favorite school subject?
If child, please number by preference (1 highest-6 lowest):
Playing outside:
Singing & dancing:
Arts & crafts:
Reading:
TV/Movies:
Boardgames:
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| Name (student #3):
Age:
Month/Day of birth:
Female
Male
Type of class: Adult
Teen
Junior
Programa Amiguitos
Not Sure
Previous Spanish?
Interests/hobbies?
If child, shy or outgoing?
If child, favorite school subject?
If child, please number by preference (1 highest-6 lowest):
Playing outside:
Singing & dancing:
Arts & crafts:
Reading:
TV/Movies:
Boardgames:
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| Name (student #4):
Age:
Month/Day of birth:
Female
Male
Type of class:
Teen
Junior
Programa Amiguitos
Not Sure
Previous Spanish?
Interests/hobbies?
If child, shy or outgoing?
If child, favorite school subject?
If child, please number by preference (1 highest-6 lowest):
Playing outside:
Singing & dancing:
Arts & crafts:
Reading:
TV/Movies:
Boardgames:
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| Name (student #5):
Age:
Month/Day of birth:
Female
Male
Type of class:
Teen
Junior
Programa Amiguitos
Not Sure
Previous Spanish?
Interests/hobbies?
If child, shy or outgoing?
If child, favorite school subject?
If child, please number by preference (1 highest-6 lowest):
Playing outside:
Singing & dancing:
Arts & crafts:
Reading:
TV/Movies:
Boardgames:
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| Name (student #6):
Age:
Month/Day of birth:
Female
Male
Type of class: Adult
Teen
Junior
Programa Amiguitos
Not Sure
Previous Spanish?
Interests/hobbies?
If child, shy or outgoing?
If child, favorite school subject?
If child, please number by preference (1 highest-6 lowest):
Playing outside:
Singing & dancing:
Arts & crafts:
Reading:
TV/Movies:
Boardgames:
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| SECTION FOUR - HOUSING if not needed proceed to Section Five: |
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Housing requirement:
With a host family - 3 daily meals
Small Guest House - 3 daily meals (ask about wait list for large guesthouses)
Small Guest House - without meals
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| How many bedrooms? | |
| How many bathrooms? | |
| Housing arrival date: | |
| Departing housing: | |
| Do you smoke? |
No Yes, outdoors |
| Do any of you need vegetarian meals? Note who: |
| Other housing details: |
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| SECTION FIVE - other helpful info: |
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| If some in your family are coming for different dates, please list below: |
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| If you found us online, where did you learn about us? |
| If a friend recommended you, can you tell us who it was? |
| Your cell number, if traveling to Mexico with your cell phone: |
| Name and phone number of your emergency contact: |
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| SECTION SIX- Questions/comments/requests: |
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| SECTION SEVEN - TO SUBMIT TYPE IN WORDS AS SHOWN BELOW: |
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