Solexico Registration

PERSONAL INFORMATION:

First Name:

Last Name:

Address:

City:

State:

Country:

Zip Code:

Date of birth:

Sex:
 Male Female

Nationality:

Telephone:

Email:

College, University or School Attending /ed:

Occupation:

Have you studied Spanish?:
 Yes No

Other languages?:

Probable Spanish level:
 Beginning Intermediate Advanced

Reasons for learning Spanish?:

How did you hear about Solexico?:
 Friend Searching on the Web Agency Other

DESTINATIONS

Playa del CarmenPuerto VallartaOaxaca

TYPE OF PROGRAM:

* Type of Program you wish to enroll in:

Regular Spanish Courses 15 hrs/wRegular Spanish Courses 25 hrs/wSpanish Individual ProgramSpanish Executive ProgramSpanish Professional Programs 25 hours/wKid’s ProgramsEducators of Spanish as a Second Language 25 hours/wOaxaca seasonal Spanish Culturalvolunteer ProgramSpanish & Activities in Playa del Carmen

Comments

Planned Date of enrollment: (Starts on Monday)
...

Number of weeks:

Type of Housing Plan you wish to enroll in:
Private RoomShared RoomResidenceIndependent housing

 Half Board Breakfast

(We suggest that students arrive a few days before beginning classes on Monday so they can meet with families).

* Planned date to begin housing accommodation:
Start day:
...



End day:
...

Restrictions or allergies to food or animals:

Bothered by cigarrette smoke?:

Interests and hobbies:

FLIGHT INFORMATION

Airline:

Flight No:

Date of arrival:
...

Time of arrival:

City of departure:

TRANSPORTATION (only Playa del Carmen).

Do you need transportation from and/or to Cancun?:
 Yes No

EMERGENCY INFORMATION

In case of emergency, contact:

Name:

Address:

Telephone: