Comunicar Reservation Form

REGISTRATION FORM

INSTRUCTIONS: Please print this form out and fax it to Comunicar at (506) 441-4606

Name:
Address:
Phone:
Fax:
Age:
Sex:	M F
Nationality:
Profession:
Passport Number:
Do you wish to be picked up at airport?	Yes No
Date / Time / 3 of Arrival Flight
Spanish Program Enrolling for
Check Spanish Level:	Beginners Level High Beginners Level Intermediate Level Advanced Level Specialization Level
Do you want a Home - Stay?	Yes No
If so, please state any allergies or preferences you might have (children, pets, smoking, vegetarian food, interest, etc.)
Comments

Spanish Language Institute & Cultural Center

PO Box 487-4050
Alajuela, Costa Rica
Tel: (506) 442-3279
Fax: (506) 441-4606