Registration

General Spanish - Personal Info


Contact Details





Last Name

First Name

Gender	Female Male

Date of Birth (dd/mm/yyyy)

Address

City

Zip / Postal Code

Country

Nationality

I found Expanish through (please be specific)

Passport Number

Home Telephone

Email Address

Profession / Field of Study

Work Status New layer...

Other Telephone

Alternative Email

Native Language

Other Languages Spoken

Current Spanish Level

Info


If you are registering for a ‘Special Package’ it is not necessary to complete the sections titled Program Details or Accommodation Details. Please go straight to Accommodation Preferences and follow the form through from that point.

Program Information


Program Details

Program

For private lessons or costomized content please indicate the number of hours per week you would like to have

From (dd/mm/yyyy)

To (dd/mm/yyyy)

Accommodation Details

Accomodation Preferences


Accommodation Preferences

Are you a smoker?	Yes

Do you mind living with smokers?	Yes

Do you mind living with children?	Yes

Do you mind living with pets?	Yes

Do you suffer from any allergies?

Do you have any special dietary needs?

	I am part of a couple requiring a shared bedroom

Do you have any additional or special needs?

Additional Comments

Activities & Workshops

Volunteer Placement


Volunteer Placement Details

Would you like a volunteer placement?	Yes No

Students must be willing to commit to at least 6 weeks of volunteering in the same location and must have at least a lower-intermediate level of Spanish

Please briefly describe your volunteer interests:

Start Date (dd/mm/yyyy)

End Date (dd/mm/yyyy)

Special Packages


Special Packages

Spanish and Tango in Buenos Aires

Spanish and Wine in Buenos Aires

Spanish and TEFL

Start date (dd/mm/yyyy)

Additional Comments

Arrival Information


Arrival Information

Do you desire aiport pick-up?	Yes No

Date of Arrival (dd/mm/yyyy)

I have not booked my flight; this is an estimated arrival.

Time

Departure City

Flight Number

Airline

Additional Comments

Support Services


Additional Services

Would you like to practice your Spanish with a conversation partner?	Yes No

Emergency Contact


Emergency Contact Information

Last Name

First Name

Address

City

Zip / Postal Code

Country

Nationality

Home Telephone

Email Address

Other Telephone

What is your relationship with this person?

Health Insurance Expanish highly recommends that all students have comprehensive international health and travel insurance abroad for the full duration of their program. For those who wish to purchase insurance, Expanish has teamed up with CareMed International to offer students two comprehensive travel and medical insurance packages at affordable monthly rates to ensure international coverage for our students.

I would like to be sent more information about ViaSpanish/CareMed International Health & Traveler's Insurance.	Yes

Additional Information


Additional Information

Interests

Expectations

Comments

By ticking the box labeled "Yes" I agree to the Terms and Conditions of Expanish and declare the above information to be true. I understand an invoice for program fees will be sent to me shortly after my registration has been received and that my registration will not be completed until the proper payment has been received.	Yes No

Payment Information


Payment Details

	A deposit of minimum U$S 500 (or the full amount for programs less than U$S 500) is required to confirm class registration and accommodation. For programs over U$S 2500, a deposit of 20% of the total program fee is required to confirm registration. You will receive an invoice shortly after you submit your registration, the program deposit that is due upon receipt, and the full balance is due four weeks before the program start date. *If registration is submitted less than four weeks before program start date, the full program fee will be due upon receipt of the invoice.

I would like to pay the deposit only at this time (if more than 4 weeks before the program start date)

I would like to pay the full program balance at this time

Method of Payment

Additional Comments

Untitled Document

Visit Us: Viamonte 927 1a yb
C1053ABS, Buenos Aires, Argentina

Special Packages

»Spanish and Tango
»Spanish and Tefl