<p> Academia Tica Enrolment form</p><p>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 ______</p><p>School location Academia Tica Coronado ___ Academia Tica Jacó ___</p><p>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)</p><p>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</p><p>For the following time period: from / / to / / </p><p> www.academiatica.com [email protected] tel +506-229-0013 fax +506-292-7136  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</p><p>Comments ______</p><p>Transfer information I require the following airport transfers __ on arrival only __ on departure only __ both transfers in & out</p><p>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.</p><p>Arrival and departing information I will arrive on the following date / / Airline ______Time______Flight No. ______</p><p>I plan to depart on the following date / / </p><p>Tours If you plan to arrive early, would you like to go on a tour before your course starts? Yes __ No __</p><p>Comments ______</p><p>I have read the terms and conditions and agree to abide by them. Registration is not complete until full payment is received. Signed:</p><p>______/ / Signature Date </p><p> www.academiatica.com [email protected] tel +506-229-0013 fax +506-292-7136</p>