| INSCRIPCION / REGISTRATION FORM |
| SOBRE USTED / ABOUT YOU: |
| First Name |
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| Last Name |
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| Nationality |
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| Fecha de Nacimiento / Date of Birth (dd/mm/yyyy) |
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| Passport number |
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| Su idioma natal /Your own language |
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| Gender: |
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| Dirección / Address |
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| City |
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| Country |
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| Post Code |
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| house telephone (Country and area code) |
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| office telephone (Country and area code) |
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| Cell phone ( mobile number) |
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| Email. / Your email: |
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| Ocupation |
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| Who will be paying for your course? |
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| Your level of Spanish knowledge |
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| YOUR COURSE |
| Course |
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Number of weeks that you are going to study with us? |
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| Course starting Date (dd/mm/yyyy). |
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| YOUR ACCOMMODATION |
| D/ Do you want Nueva Lengua to organize your accommodation? |
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If yes:
Accommodation type |
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| Arrival date (dd/mm/yyyy) |
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| Departing Date (dd/mm/yy) |
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| Do you smoke? |
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| Do you have any medical condition |
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| if yes, explain: |
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| TRAVEL INSURANCE |
| Tiene usted algún tipo de suguro médico para su viaje? |
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| AIRPORT TRANSFER
You can provide this information later |
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We will arrange your airport transfer, so please provide us your arrival details:
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| Arrival date (dd/mm/yyyyy). |
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| arrival time ( 24 hours). |
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| Flight number |
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| airline |
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| Do you want to pay at least 6 months before arrival and have a discount of 40 USD
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Please give us another email address if you do not have another one then please confirm the email address yo provided above: |
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Como supo de nosotros : |
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any comments? |
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