Registration Form

Personal Information
Full Name*

First NameLast Name
Nationality*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Mobile/Whatsapp number*

Area CodePhone Number
Birth Date

MonthDayYear
Occupation
Course Details
Spanish Course
Course Length
Start Date

DayMonthYear
Current Spanish Level*
Please list any previous Spanish courses or experience*
Comments
Homestay

Stay and practice your Spanish with a local family
Do you want a Homestay?

yesno
Do you have any allergies or special diet?

yesno
Special Diet type

Vegetarian ($60/w)Gluten Free ($60/w)Vegetarian + Gluten Free ($80/w)Peanut Free ($60/w)
Check-in

MesDíaAño
Fecha
Check-out

MesDíaAño
Fecha
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