Online Registration Form
Please answer all of the following questions:

Send this to:

European Office

North America Office

Personal Details

First name:
Last name:
Country:
Home phone:
Address:
Work phone:
Fax:
Email:

Emergency Contact Details

Please give the details of a person who we can contact in case of an emergency:

First name:
Last Name:
Home phone:
Address:
Work phone:
Fax:
Email:

Enrollment Details

On which Monday do you wish to enroll?	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2006 2007 2008 2009
For how many weeks do you intend to study?	1 week 2 weeks 3 weeks 4 weeks 5 weeks 6 weeks More than 6 weeks
In which school would you prefer to study?	PLQE Quezaltenango Escuela de la Montaña
Current level of Spanish:	Beginner Intermediate Advanced
How did you hear about La Hermandad Educativa?

Other Information

Please briefly answer the following questions:

Do you wish to do volunteer work during your stay?
Do you have any special dietary requirements?
Do you have any allergies or other medical conditions?
Do you have any preferences regarding the host family?
Have you studied Spanish before?
What particular interests do you have concerning Guatemala and Latin America?
Do you think that industrialized nations play a constructive role in the political and social stability of Latin America?
When you return home do you plan on making presentations about your time in Guatemala to friends or colleagues?
Is there anything else you would like to tell us?

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