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item |
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I wish to apply for the Seminar
for Medical Professionals at CPI Heredia
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Name:*
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Personal
Information
Tell us about yourself
Only one person per application!
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Gender:*
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Age:
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Marital Status:
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Occupation:
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Nationality:
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Do you
have any health problems?
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Emergency contact:*
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Native language:
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Mailing Address:*
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Your
Address
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City:*
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State:*
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Zip Code:
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Country:*
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Email Address:*
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Phone Number: *
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Cell Phone Number: * |
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Educational Background:
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Educational
Information
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University:
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At what point are you
in your studies?
(ie. 4th yr, etc.)
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Have
you studied at a language school before? (If so, where?):
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Please describe your
ability to understand and speak Spanish:
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| In which area or specialty would you
like to work/observe? (if applicable): |
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Clinical Practice |
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If
you are staying with host family, do you have any special requests:
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Accommodation
Information
Please indicate here if you have any allergies,
health problems or food restrictions and also mention any interests
and hobbies that you have
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If
not staying with a host family, what type of accommodation are
you looking for? Specify if you would like reservations made:
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Arrival date:
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Arrival
Information
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Arrival time:
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Airline:
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Flight number:
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*Departure
city:
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*Please
tell us your connecting flight details INTO San
José.
If you have not made flight reservations yet, no
need to worry! Please forward us your arrival information when
you have it.
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Please note: We
strongly recommend that you fly into San José the Sunday
afternoon before your classes begin.
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How did
you hear about CPI?
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Other Questions
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What
is your motivation to learn Spanish?
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Comments, Questions
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item |
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Before submitting
your application please check that you have filled it in correctly.
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