ENROLLMENT FORM

Please fill and send this form with the Submit button, if you make a mistake erase the field with the mouse and correct it.
Name:Age:
Address:City:
State:Zip:
Country:
Telephone: Bus:
Fax:E-Mail:
Weeks:
Course:
Intensive
Executive
Arrival Date::
Apply for University Credit: Yes No
Speak Spanish (%):
Transfer from Mexico City Airport to Cuernavaca ?
Flight No.: Airline:
From: Arrival Time:

Housing Plans: Luxury Plan ($32) private room, private bath room, pool, garden, three meals and transportation.
Plan "A" ($24) private room, shared family bath room, three meals.
Allergies? Smoke? Vegetarian?
Roommate? Yes No Name:

 

The Registration Fee of US$100 ensures a place in the class and is a single fee for life, when you return again you donīt have to pay the registration fee any more.
Checks are made payable to Centro Bilingue or can be paid at your arrival to the school. The full tuition, as quoted, can be paid to Centro Bilingue by check or upon arrival in Cuernavaca by credit card, either currency or travelers checks. If using an airport transfer the driver is to be paid by travelers checks or cash on either currency.
If you want to send your registration fee by mail send it to:

Isabel C. de Lozano
Centro Bilingue de Cuernavaca
E-mail: isaloz@van-graff.com, jmlozano@van-graff.com
Nueva Polonia # 189, Lomas de Cortes
Cuernavaca, Mor. 62251
Tel (777) 311-30-72; (777) 311-40-70



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