:: INSTITUTO LENGUAS VIVAS :: Escuela de Idiomas

:: Enrollment ::

APPLICATION FORM

Enrollment is fast and easy. You just need to fill out the Application Form and send it (through our website, e-mail or fax).
We will make all reservations and send you an e-mail confirming all the details regarding the program of your choice (courses, accommodation, airport transfer, and others).

For more information please contact us
info@lenguasvivas.org
www.lenguasvivas.org
++ 54 2944 441249 (phone)
++ 54 2944 428775 (fax)

LAST NAME
FIRST NAME
GENDER	M F
NATIONALITY
AGE
DATE OF BIRTH
ADDRESS
CITY
ZIP CODE
STATE / PROVINCE
COUNTRY
(home) PHONE NUMBER
(work) PHONE NUMBER
FAX
E-MAIL
CONFIRM YOUR E-MAIL
OCCUPATION / PROFESSION
COMPANY / SCHOOL / UNIVERSITY

HAVE YOU STUDIED SPANISH BEFORE?
	Yes No
IF YES, HOW LONG HAVE YOU STUDIED?

WHERE?

NOTIFY IN CASE OF EMERGENCY
NAME
RELATIONSHIP
PHONE NUMBER
COUNTRY

PROGRAM CHOSEN
	1 WEEK
	2 WEEKS
	3 WEEKS

COURSE STARTING (only if applicable)
MONTH
DAY
YEAR

PREPARATION COURSES (Distance Education Modality) (only if applicable)


FOLLOW UP COURSES (only if applicable)


ACCOMMODATION
TRANSPORTATION	Buenos Aires – Bariloche – Buenos Aires
AIRPORT TRANSFER

ADDITIONAL INFORMATION
ANY HEALTH PROBLEMS WE SHOULD KNOW ABOUT?

DO YOU SMOKE?

DO YOU HAVE ANY SPECIAL NEEDS?

HOW DID YOU HEAR ABOUT OUR PROGRAMS? (PLEASE SPECIFY)

DID YOU CONSIDER OTHER PROGRAMS?

WHY DID YOU CHOOSE US?


After enrollment you will receive a SPT (Spanish Placement Test in order to determine your Spanish Language level.)
Please double-check all information on this form before submitting

INSTITUTO LENGUAS VIVAS
Gallardo 40 - San Carlos de Bariloche - CP8400 - Río Negro, Argentina - Te. +54 2944 428775
http://www.lenguasvivas.org - info@lenguasvivas.org - secretaria@lenguasvivas.org