Registration Form

You are on your way to speaking better Spanish... To reserve your space in our program just fill out the following registration form and submit it. To complete your registration we require a non refundable $100.00 usd deposit. The deposit will be deducted from your course fess. You will not pay anything else until your first day of class once in Puebla, Mexico. Your cost will NOT change once the deposit is received.

Personal Information

Name

Home Phone

Cell Phone

Sex

Address

Profession

Marital Status

Age

City

State

Zip Code

Country

Person in case of emergency

Name

Phone Number

Program Information

Please select your program.

Group program
More information

Group program: *

No. of weeks: *

Private program
More information

Private program: *

No. of weeks: *

Host Family

Do you want host family?

Yes

Spanish Level

Take placement test (optional)

What is your approximate Spanish Level:

Knowledge of Spanish (25 words or less):

Deposit ($100 usd) will be paid by

Credit Card

Check

(Only accept)

Check this box if Billing Address and Mailing Address are the same.

Please, use this space for your comments

How did you find out about the Spanish Institute of Puebla?

Former Student

Employer

Ad in newspaper / magazine

My University

Web search

Other source

Have any Question?

If you have any question about the Spanish Institute of Puebla feel free to ask:

Email

info@sipuebla.com

Phone

1-800-554-2951
(USA & Canada)

Phone

+52-222-242-2062
(Other Countries)

Address

11 Oriente #10, Centro Histórico. Puebla, Pue 72000.