Name:*
Date of birth:*
Gender identity (optional):
Citizenship (for visa requirements verification purposes): *
Mailing address: *
City / Locality: *
State / Province:*
Zip / Postal Code:
Country:*
Phone:*
-
E-mail:*
Passport number: *
Current degree:
Academic institution: *
Major/Area of concentration: *
Do you have student health/travel insurance?:*
Name of the Company:
Spanish level:
1
2
3
Preferred term:*
1. Select the date for your enrolment and the courses you wish to take (Please note that a Maximum of 15 credits are allowed, but select as many as you want. The acceptance of the courses will be based on your official transcript and the availability of spaces in each course, courses may change without notice and selecting one does not secure your spot on it)
Please select your courses for September 4th, 2017:
Please select your courses for January 15th, 2018 :
I Period - January 15th, 2018 - Select:
II Period - January 15th, 2018 - Select:
Please select your courses for May 7th, 2018 :
I Períod - May 7th, 2018 - Select:
II Períod - May 7th, 2018 - Select:
Please select your courses for September 3rd 2018 :
2. Would you like to participate in our intensive intercultural Spanish Program prior your arrival?
For more information please click on the following link
Contact Name :*
Phone (cell):*
-
Phone (home): *
-
E-mail address:*
Relationship to you:*
Do you take medicines regularly? *
Please specify:*
Do you have any serious allergies?*
Please specify allergies:*
Are you allergic to any medicines? *
Please specify medicines:*
Are you allergic to any food? *
Please specify food:*
Are you allergic to insect stings or bites?*
Please specify insect:*
Do you have any dietary restriction?*
Please tell us:*
Please upload the following documents:
Please submit the copy of your valid Passport (2 mb Pdf Only)*
Please submit the copy of your official transcript (If you do not have the official transcript please submit the unofficial one and request to your University to send the official transcript to lreyes@earth.ac.cr)(2 mb Pdf Only)*
Record of Spanish learning (e.g., transcript showing how many university-level courses you have taken or if you are a native Spanish speaker re-upload your transcript)(2 mb Pdf Only)*
Please submit a brief statement of purpose (2 mb Pdf Only)*
Please submit a copy of your travel insurance (2 mb Pdf Only)
Submit other documents to support your application (2 mb Pdf Only)
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