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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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