Registration

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

Upon submission, you will receive an automated acknowledgement email in the next few minutes. If you don't, please check in your Junk mail folder. If you experience problems filling out the registration form online, download the printable version and send it by regular mail address.

Name * Title First Last Suffix
Address *
Street Address

Address Line 2

City

State / Province

Postal / Zip Code

Country
Home Phone * - (###) - ### ####
Email *
Business Phone - (###) - ### ####
Fax Number - (###) - ### ####
Year of Birth (yyyy)
Notify in Case of Emergency
Emergency Contact Name *

What is the name of the person who should be notified in case of emergency?
Relationship *

What relationship does exist with this person?
Emergency Phone * - (###) - ### ####
What is his/her phone number?
Emergency Contact Country *

What is the country?
Spanish Language Program
Please choose the program in which you want to be enrolled: * Basic BasicPlus One-on-One
Please consult section "Our Program" for more information about our different programs
Which date would you like to begin? * / MM / DD YYYY
For how many weeks? *
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
Reading
Writing
Speaking
Accommodations
Choose your accommodation option: * Homestay On-campus housing Apartment I will arrange my own accommodation
Would you like to have a private room? *

Please consult the "Accommodations" section to see the differences in prices
Do you require special food or diet? Please describe:
Do you have allergies (to cigarette smoke, pet hair, etc.)? Please describe:
Do you require any special medication? Please describe:
Do you have a physical condition? Please describe:
Do you smoke? *
Travel Arrangements
Airport/Bus Station Pickup I will be arriving at the Léon airport by plane. I will be arriving in Guanajuato by bus.
Date of Arrival / MM / DD YYYY
If you have not completed your travel arrangements, simply notify us when you will have that information
Bus Company/Airline & Flight No.
Bus/Flight Departure Time (hh:mm)
Bus/Flight Arrival Time in Gto (hh:mm)
Date of Departure / MM / DD YYYY
Other Information
How did you hear about Instituto Miguel de Cervantes?
Are there any other comments you'd like to add to your registration?
Did you consider other programs? Why did you choose ours?
To help us advertise more efficiently, can you tell us what keywords you used to find us?

Registration

Notify in Case of Emergency

Spanish Language Program

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

Accommodations

Travel Arrangements

Other Information

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