The Classes arrow Application Form
Application Form
Surname:
  *
Firstname:
  *
Nationality:
First language:
  *
Birthday:
Passportnumber:
Sex:
Occupation:
How did you hear of Rocío Language Classes?:
Home Address:
Telephone:
E-mail:
  *
Address in Arequipa:
Telephone:
Name of employer,school or university:
Address of employer,school or university:
Do you speak another language?:
If yes Which?:
What is your present level of Spanish?:
Where do you learn spanish?:
How long?:
Number of weeks required:
Course start date::
Course finishing date:
Do you want One-to- One lessons?:
If yes, how many hours per week?:
At which time?:
Do you wish RLC to arrange accommodation for you?:
Peruvian familie:
Simpleroom
private bath
doubleroom
shared bath
Food:
Two meals(breakfast/dinner)
Three meals (b/d/l)
Hostal / hotel:
Simple room
doubleroom
private bath
shared bath
Number of weeks:
Arrival date::
Departure date ::
Do you smoke?:
Do you have any allergies?:
if yes, please state:
Are you vegetarian?:
Do you object to dogs?:
cats?:
Do you require an airport transfer?:
* Required field
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