Academia Tica Enrolment Form

Academia Tica Enrolment form

Personal information__ Male __ Female

First name ______Middle name Last name ______

E-mail address ______

Home Telephone _____Work telephone _____Fax _____

Date of birth // Nationality ______

Mother tongue ______Other languages ______

Occupation ______

School location

Academia Tica Coronado ___ Academia Tica Jacó ___

Course information

I want to reserve the following course ______

with ___ 20 ___ 30 ___ 40 lessons per week

My level of Spanish is _Beginner _ Intermediate _ Advanced

For the following time period from //to//

(courses go from Monday to Friday)

Comments ______

(not all courses are available at Academia Tica Jacó)

Special programs

I am interested in registering/ receiving information about

____ Internship or ____ Volunteering

Comments ______

Accommodation information

I am interested in the following type of accommodation

___ No accommodation needed

___ Family Standard___ Family Standard plus

___ Apartment

___Single__ Double

For the following time period: from//to//

• It is OK to reserve a space for periods of time before or after the course, or even with no course
• An accommodation week goes from Sunday to Saturday Additional nights are charged at the extra night fee

Comments ______

Transfer information

I require the following airport transfers

__on arrival only__ on departure only __ both transfers in & out

Homestay includes airport pick-up transfer at no charge.

Apartment does not include airport pick up transfer.

Transfer in or out can be arranged with the school for us$22 one way.

Arrival and departing information

I will arrive on the following date //

Airline ______Time______Flight No. ______

I plan to depart on the following date //

Tours

If you plan to arrive early, would you like to go on a tour before your course starts? Yes__ No__

Comments

______

______

______

______

I have read the terms and conditions and agree to abide by them. Registration is not complete until full payment is received. Signed:

______//

Signature Date

tel +506-229-0013 fax +506-292-7136