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ICAS
Mesoamerica Language Program
Enrollment Form

I would like to enroll in your Spanish Language Program.

Please make arrangements for weeks of study for person(s).

Name & Address of Student:

First Name

Last Name

Address

City

State

Zip

Country

Email

Confirm Email

Phone

Age

Level of Spanish Study

Period of Study From

Period of Study To

(Please list the names of any other students for whom you are making reservations.)

I would like to take part in your homestay program. 
 Please place me with a Costa Rican family for the following dates.

HomeStay From Date

HomeStay To Date

I would like to be met at the airport; Below is my flight information.

Airline

Flight #

Arrival Date & Time Time

Flight information forthcoming.

Please indicate any special requirements you may have; i.e. nonsmoking, vegetarian, etc.


Instructions

Upon clicking submit, you will be presented with the opportunity to submit 
payment of your $50 deposit on-line through PayPal.

OR:

Print out the form and mail it to :

Institute for Central American Studies (ICAS)
Apartado 1524-2050
San Pedro, Costa Rica

Tel: +(506) 253-3195
Fax: +(506) 234-7682
mailto:info@MesoamericaOnline.Net

Form must be accompanied by a $50 deposit via a US$ check.
Please make your check payable to ICAS.

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