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    PERSONAL INFORMATION

    Name*

    Last*

    Gender*

     

    Day of birth

    Month of birth

    Year of birth

    Nationality*

    Occupation

    Email*

    Phone 1*

    Phone 2

    ENROLLMENT

    Program you are enrolling for:

    Number of weeks:

    Type of classes:

    Hours per day

    Days per Week

    Dates you will be at the academy?

    IN / First day classes

    Day

    Month

    Year

    OUT / Last day classes

    Day

    Month

    Year

    With homestay?

    Will you require a grade or transcript?

    Do you want to be picked up at the airport?

    Date

    Day

    Month

    Year

    Time (24 hour)

    Airline

    Flight #

    What languages do you speak?

    Have you received Spanish classes before? (Please specify)

    In what level of Spanish do you consider to be at this moment?

    How did you hear about CRLA? I am a former studentWord of mouthInternetTrip AdvisorMagazine / BookI am part of a groupOther Source

    Please specify

    Why did you choose CRLA.?

    HOMESTAY INFORMATION

    What type of lodging do you prefer:

    Room

    Atmosphere

    Diet

    Children

    Smoking

    Do you smoke?

    Do you have allergies or other relevant health problems? (Specify)
    Most Costa Rican families have pets. If you have any pet allergies or a strong dislike for pets please indicate this.

    Other preferences and comments:

    Dates you will be at the home stay:

    IN / Arrival

    Day

    Month

    Year

    OUT / Departure

    Day

    Month

    Year

    PERSON TO NOTIFY IN CASE OF EMERGENCY

    Name

    Last

    Phone 1

    Phone 2

    Email

    Additional Information

    Comments NOTE: The information provided will be used to make the best possible match between the student and the family. Although we try to meet as many of the student's desires, we do not require that the family or the Academy provide everything that the student has checked off.

    Approximately 3 weeks prior to your class start date, you will be sent your host family information, emergency phone numbers and tips to help you get ready for your trip. In one or 2 days (or 3 days during the weekend), you will receive an e-mail verification upon receipt of your application. 

    LEARN SPANISH & LEAVE A POSITIVE FOOTPRINT

    CRLA students have the opportunity of contributing to make a tangible difference in our world and to leave something positive for future generations.

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