Spanish Programs Form by j.batres Name & Last Name *Date of Birth: *Sex: *MaleFemaleOtherPhone *Email Address *Emergency Phone Number *Street Address *Apartment, suite, etc *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePassport # and Nationality *Interests / Hobbies *CollegeStudies *High SchoolUniversityOtherIf other, please specifyDo you wish to receive college credits? *Yes ($15 for handling paper work when applying for college credits)NoIf Yes, answer the question below How many credits do you wish to obtain? and name of the University. *What kind of credits are you applying for? * *College CreditsOthersPlease specifyLanguages (find your Level Written/Verbal) Spanish LevelNative LanguageOther LanguageHave you studied Spanish? *YesNoIf yes, answer where and how long?Language school and/or Literature classes (You wish study) *K'iche'MamRegular SpanishAccelerated SpanishAcademic SpanishSpanish for travelersTest Preparation for TeachersSpanish OnlineSubjuntiveCurrent Events in GuatemalaRural SpanishWhen do you want to start your classes? *How many weeks do you want to study? *The focus of your Studies will be *Personal InterestCLEPPraxis PPSTOPIDELESAT II SpanishSpanish for BusinessSpanish for ChildrenSpanish for Health Care ProfessionalsSpanish for EducatorsMedical SpanishotherIf checked othersPlease enter here the kind of literature you want to study:Family Special dietaryFamily Special dietary needs *NoVegetarianVeganOtherIf checked otherI would rather live with a family *Whith ChildrenWithout ChildrenPetsNo PetsNear of buildingHealthAllergies *Medical problems *Travel information (If known)Would you like to be met at the airport? *YesNoWhich Airport?AirlineFlight #Date of arrivalTime of arrivalHoursMinutesAMPMInquiryWhere did you learn about Casa Xelajú? *Please mail out $50.00 registration and deposit x numbers of weeks you will study to Casa Xelaju, 4701 Zenith Ave. S., Minneapolis MN 55410. Total amount to advance (US $) *Comments and suggestions would be appreciatedAcknowledge that I have read and understand the conditions presented and understand my financial obligations which begin upon receipt of my confirmation. *I've read terms and conditionsSend Message
