Intercultura Language School, Heredia, Costa Rica

To register, simply fill in the following form, then return it here on-line, by mail, fax, or call us with your registration information.

Please advise us of your flight date, airline, number and arrival time so that we may be at the airport to meet you (if you do not yet have this information, you may send it to us separately at a later date). Extra fees apply for airport pick ups, please inquire.

** Please see the National Holidays listed at the end of this form before submission.**

Fields with asterisks are required *

*NAME:

*EMAIL:

ADDRESS:

*TEL. #:

FAX #:

AGE:

<< Minimum age 18 >>

MALE:

FEMALE:

COUNTRY:

PROFESSION:

PASSPORT NUMBER:

Which website, agency or other source did you find Samara Language School through?

PICK ME UP AT THE AIRPORT:

YES:

NO:

DATE:
TIME:
AIRLINE
FLIGHT #

LENGTH OF PROGRAM DESIRED FOR BOTH CAMPUSES (weeks):

CLASSES DATES IN HEREDIA
(MAIN CAMPUS):

FROM:
TO:

FROM:
TO:

CLASSES DATES IN
SAMARA BEACH
(BEACH CAMPUS):

FROM:
TO:

FROM:
TO:

SPANISH LEVEL:

	COMPLETE BEGINNER: (no previous Spanish study)
	MID-BEGINNER: (present tense, simple sentences, basic comprehension)
	INTERMEDIATE: (future, past, present tense, some conversation)
	ADVANCED: (subjunctive, reading, writing, conversation)

WOULD YOU LIKE A HOMESTAY?:

YES:

NO:

Start date in Heredia homestay:

FROM:
TO:

FROM:
TO:

Start date in Samara homestay:

FROM:
TO:

FROM:
TO:

Would you like to be the only foreign student in your family?:

YES:

NO:

Please state any preferences you might have regarding your homestay (children, pets, smoking, vegetarian food, etc) and any relevant physical concerns we should be aware of:

ADDITIONAL COMMENTS:

CREDIT CARD NUMBER:Please call or mail Samara Language School your credit card information in order to guarantee your reservation. Nothing will be charged to your card until you arrive, or in the event of a no-show. (info@interculturacostarica.com)

NATIONAL HOLIDAYS: The following dates are national holidays in Costa Rica, during which classes will not be held. There are no discounts for for those which fall on school days, so you should take this into account when planning your study dates:

2008
JANUARY 1:	New Years Day
MARCH 17th to 21th:	Easter Week
APRIL 11:	Juan Santamaría Day (Costa Rica's national hero)
MAY 1:	Costa Rican Labour Day
JULY 25:	Annexation of Guanacaste
AUGUST 15:	Mother's Day
SEPTEMBER 15:	Costa Rican Independence Day
OCTOBER 12:	"Día de la Raza" Indigenous Peoples' Day
December 15 to December 19:	Professional Development Week
DECEMBER 22 (2008) to January 2 (2009):	Christmas Holiday

Location II Spanish Instruction II Beach Campus II Cultural Activities II University Credit II Volunteer Opportunities II Homestays II Price List II Registration Form II References II Photos II Staff II Contact Us II EFL Program II HOME
INTERCULTURA, Costa Rica, Language School & Cultural Center
Address.	P.O Box 1952-3000, Heredia Costa Rica, Central América
E-mail.	info@interculturacostarica.com
Tel/Fax.	+(506) 2260-8440 / 2656-0127
TOLL FREE NUMBERS	USA/Canada: 866-978-6668 / 213-784-4897
	Europe: 44-20-7993-0822

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DOCTOR WEB