ACADEMIA HISPANO MEXICO

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APPLICATION FORM

Last Name:       First Name:  
Address:  
Telephone:  
Fax:  
Email:(Very important)  
 

Date of Birth:  
Sex:    Male  Female 
Occupation:  

Presonal aim for thislanguage course:           
                
In case of emergency, notify:  
Native Language: 
Other languages you speak/write:  
Arrival date at housing:  
Departure date: 
Date you wish to begin classes:  
Date of last class: 
Hours/day you wish to study (Mon - Fri):  
Total weeks: 
How did you hear about our school?:             
                

COURSE LEVEL (circle two levels if you are not sure of your level)
 Absolute Beginner 
 Beginner 
 Elementary
 Intermediate
 Advanced
 Superior

One - on - one tutoring: 
Group classes (all groups may have 2 - 5 students): 

HOME STAY
 Single room
 Vegatarian diet
 Home with children 
 No children
 No pets
 Non-smoking
 Smoking
 Have allergies

Do you have any other special needs or request?:                
                

1.- REGISTRATION

 Registration becomes valid when the applicant receives notice of acceptance from the Director of the Academy.

 2.- CANCELLATION OF REGISTRATION

 Applicants may request cancellation of registration, by registered mail, until 30 days before the commencement of the course, in which case the reservation fee will be refunded. No refunds will be paid for cancellations requested less than 30 days before commencement. The franking date on the envelope will be taken as the date of cancellation request.

3- CONDITIONS OF CANCELLATION BEFORE OR DURING THE COURSE

 Subsequent to payment of the total price of the course, this may be cancelled due to serious illness, accident or decease of the student, his/her parents, spouse or children, in which case the total price will be refunded. A medical certificate will be re quired in evidence of the stated cause, to accompany the cancellation request.

4.- ABSENCE AT THE COMMENCEMENT OF OR DURING THE COURSE

 Persons arriving late for the course, absenting themselves or abandoning the course, shall have no right to a refund. The Academy has no obligation to make up time lost by students through absence. We reserve the right, in the interests of all concerned, to expel any student violating the rules of social conduct or the laws of the country. In such cases there shall be no refund.

5.- All courses at Academia Hispano Mexico are open to persons of any, sex, race or religion.