APPLICATION FORM
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Name:
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Nationality / Town: City of Residence
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e-mail adress
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Birthday:
Month
January
February
March
April
May
June
Julio
Agosto
September
October
November
December
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Profession:
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Phone number in your country:
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Phone number in Buenos Aires:
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Address in Buenos Aires:
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University / Organization you will join in BA (optional):
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Languages you can speak:
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Spanish Level
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Have you ever studied Spanish Before?
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How long?
Are you familiar with the following tenses? (Complete by using, very good – good - no):
Very
Good
No
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Presente Indicativo (yo camino):
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Presente continuo (yo estoy caminando):
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Futuro (yo voy a caminar-yo caminaré):
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Pasado Perfecto Compuesto (yo he caminado):
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Pasado Perfecto Simple “Indefinido” (yo caminé):
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Pasado Imperfecto (yo caminaba):
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Pasado Pluscuamperfecto (yo había caminado):
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Modo Imperativo:
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Modo Potencial “Condicional”:
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Presente Subjuntivo:
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Imperfecto Subjuntivo:
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Perfecto Compuesto Subjuntivo:
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Pluscuamperfecto Subjuntivo:
Description of the course:
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Total amount of weeks:
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From:
dd.mm.yy
Month
January
February
March
April
May
June
Julio
Agosto
September
October
November
December
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To: dd.mm.yy
Month
January
February
March
April
May
June
Julio
Agosto
September
October
November
December
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Group lessons:
Hours per day:
Total amount of group hours:
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Private-group lessons:
Hours per day:
Total amount of group hours:
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Private lessons:
Hours per day:
Total amount of group hours:
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Private-group lessons:
Hours per day:
Total amount of group hours:
Accommodation (YES / NO):
YES
NO
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Host family:
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Students´ Residence
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Hostel:
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Single room:
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Shared double room:
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Dormitory room:
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Arrival date (for lodging):
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Departure date (for lodging):
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Meal plan (Optional), breakfast or dinner:
Reconquista 715 P 11º "E" - Zip code 1003 - Tel: (5411) 4312-1016 - Bs. As. Argentina -
spanish@cedic.com.ar
