Registration Form

Personal Data

Please complete a separate form for each member of your party.

First Name
Last Name
Company
Street address
City
State/Province
Zip or Postal Code
Country
Home Phone
Business Phone
Fax Number
E-Mail Address
Confirm E-mail
Date of Birth	(e.g. 1978)
Nationality
Age	Profession

  Notify in Case of Emergency

  Name

  Relationship

  Phone Number

  Country

  Spanish Language Program

  Enroll me in the program starting
        and ending , for a total of   weeks.
   Don't find the date you would like to attend? Please read about our starting dates here.

  Have you studied Spanish before?

  If yes, describe where, when, for how long, and level of study:

  Rate Yourself in Spanish         (1 = low level of skill;   5 = high level of skill)

  Listening         Speaking
  Reading         Writing

  Accommodations

I prefer the homestay option (includes pickup at Le�n airport or Guanajuato bus station, if stay is more than 1 week).
I wish to have a private room
  Do you require special food or diet? Please describe:

  Do you have allergies (to cigarette smoke, pet hair, etc.)?
  Do you require any special medication?  Do you have a physical condition?
  Please describe:

  Do you smoke?     Yes      No
  I am interested in renting an apartment at the Institute. Please send me more information about availability and prices.
  I will arrange my own accommodation.

  Airport/Bus Station Pickup

   Option #1.    I will be arriving at the L�on airport by plane.
There are international flights to Le�n from the United States via Dallas, Houston, Los Angeles, Oakland, and Chicago. Travelers may also fly direct to either Mexico City or Guadalajara and take a connecting flight to Le�n. Check with your travel agent for more information. If you are participating in our homestay program, we will arrange for you to be picked up free of charge at the airport. If you are not participating in our homestay program, we can still pick you up for an additional charge of US$37 one-way (max. 2 people). If an airport pick-up or delivery is required for more than two people, then please contact us and we'll calculate the cost depending on the number of people requiring transport.

Date of Arrival Airline

Arrival Flight No. Arrival Time

Date of Departure

  Option #2.   I will be arriving in Guanajuato by bus from

Date of Arrival Bus Company

Bus Departure Time Arrival Time in Gto.

Date of Departure

Homestay students will be met at the bus station by their family. Please call ahead to your family before departing Mexico City or Guadalajara to confirm your arrival time in Guanajuato. The bus from Mexico City takes about 5 hours, 15 minutes; the bus from Guadalajara about 3 hours, 45 minutes. In Mexico City, buses leave from the Central Camionera del Norte, Sala 1 (North Bus Terminal). Carriers are ETN, Primera Plus, or Futura, and the cost is about $250 - $300 pesos. Bus fare from Guadalajara to Guanajuato is about $250 - $300 pesos, and carriers are ETN and Primera Plus. In both Mexico City and Guadalajara, you should allow two hours from the time you deplane to get to the bus station.

  Other Information

  How did you hear about Instituto Miguel de Cervantes?

To help us advertise more efficiently, can you tell us what keywords you used to find us?

  Did you consider other programs? Why did you choose ours?

  Are there any other comments you'd like to add to your registration?

Minors

To enter Mexico, all minors travelling alone or with only one parent must have a letter from both parents giving them the permision to travel abroad by themselves. The letter has to be certified by a relevant authority in the country of origin.

All minor participants coming alone MUST bring a letter from their parents in which the parents agree to be responsible for any matter concerning their child while participating in a program at the Instituto Miguel de Cervantes. For an example of such letter, click here.

Disclaimer

The Institute assumes no responsibility for medical insurance of any kind. However, the Institute will assist students in finding local medical services, such as medicine, doctors, hospitals, etc. If you have insurance through a company in the U.S., Canada, or Europe, ask to have the benefits extended to cover you while you are in Mexico.

Please double-check all information on this form before submitting.
If you experience problems filling out the registration form, download this printable version and send it by regular mail.

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	I prefer the homestay option (includes pickup at Le�n airport or Guanajuato bus station, if stay is more than 1 week). I wish to have a private room
	Do you require special food or diet? Please describe:
	Do you have allergies (to cigarette smoke, pet hair, etc.)? Do you require any special medication? Do you have a physical condition? Please describe:
	Do you smoke? Yes No
	I am interested in renting an apartment at the Institute. Please send me more information about availability and prices.
	I will arrange my own accommodation.