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Registration

 

You represent and warrant you are at least 18 years of age or older in order to pay with a credit card.

Please accurately fill out the fields below in order to place the student or students with a host family or lodging that best fits his or her needs.

Please fill out the fields specified with an asterisk *

General Information

First Name:
*
Last Name:
*
Address:
*
City:
*
State/Region::
*
Zip Code / Province code:
*
Country:
*
 

Contact Information

Home Phone:
( ) - *
Work Phone:
( )-

Mobile Phone:
( ) -

Fax Number:
( ) -
Email:
*

Individual Information

Birthdate:
- -

(mm-dd-yyyy) month,day,year

Gender:
Occupation:
School:
Number of Children:
Nationality:
Passport Number (Optional):
Passport Expiration Date:
- -
Passport Issuing Country:

(mm-dd-yyyy)

Having your passport number can help us to help you in the case of an emergency.

Emergency Contacts:

 
#1 Contact Person [First & Last]:
Telephone:
-
#2 Contact Contact [First & Last]:
Telephone:
-

 

Additional Questions:

How did you hear about us?
*
Speak other languages? If so, what?
Why learn Spanish?
What is your level of Spanish?
Where did you study Spanish?
Hobbies:

Do you need Academic Credits?
Note: Credits need to be pre-arranged
*

Traveling alone or with someone?
#1Person [First & Last]:
#2 Person [First & Last]:
#3 Person [First & Last]:
#4 Person [First & Last]:

Program:
If choosing multiple locations fill out all designated fields. Youth Program are only designated to one location.

First School Location

[Specify city name]

If a multi-campus choice please fill out the Second/Third School Location Options


*

Program Name

[See listing for help]

 

(For example, Youth Program or Regular Spanish)


*

Private Classes One on One (Additional Cost)
Special Needs [Specify]

Start Date:
- -

(mm-dd-yyyy)

Finish Date:
- -

(mm-dd-yyyy)

   

Second School Location

[Specify city name]

Program

[See listing for help]

Private Classes One on One (Additional Cost)
Special Needs [Specify]

Start Date:
- -

(mm-dd-yyyy)

Finish Date:
- -

(mm-dd-yyyy)

   

Third School Location

[Specify city name]

Third Program

[See listing for help]

Private Classes One on One (Additional Costs)
Special Needs [Specify]

Start Date:
- -

(mm-dd-yyyy)

Finish Date:
- -

(mm-dd-yyyy)

Write in any location arrangments that might not be covered above


Lodging Preference:

Lodging?
*

(Youth Programs are with Homestay)

Other Lodging Needs? [Specify]
Health Considerations? [Diet, Allergies, Medications, etc.]
Family Requirements? [Specify needs]
   

Arrival/Flight Information
If Available (Otherwise state "TBD")

Airline Name:
Flight #:

Arrival Date:
- -

(mm-dd-yyyy)

Arrival Time:


Do you need airport pick-up?
*

Comments or Additional Questions?

* I have read and agree with the Terms and Conditions of this registration (explained farther down)

Before submission, please print this page for your records.

After you submit the form:

We'll be in contact with you to confirm program availibility status as well as other details. Once that has been done, you'll want to return to this page and forward payment to the address below or, if you're paying via credit card, click on the Paypal option below.

We recommend Bookingmarking this page for later refrence.

To pay by check or money order, send deposit to:

SFM Processing Center

P.O.Box 29637

Los Angeles, CA 90029-0637

get currency conversions

To pay by Credit card:

 

Click here for instructions to pay with a credit card via PayPal

 

 Visa Mastercard Discover American Express eCheck

 

Paypal is an internationally recognized, secure third-party transaction service. This is an electronic form of payment.

PayPal-Spanish for Medical to make fast, easy, and secure payments for your SFM transactions!

TERMS & CONDITIONS:


Registration/Enrollment and Payment

To insure a space at any Spanish for Medical program, it is important to register as far in advance from your desired start date as possible (Summer Programs are encourage to register as early as possible).
Registration consists of:
1. Submitting a completed registration (online or printed and faxed with signature)
2. 20% Deposit from the total program amount is due four weeks prior to start date. Remaining balance is due at the school location.
3. Payments can be paid online wity Paypal.com or Personal Check , money order, VISA, Mastercard, American Express or Discover. (Personal check is Preferred!)

Upon receiving your registration, Spanish for Medical will send you the partial confirmation via email or regular mail. After receiving the other missing information (such as airline itineraries), a final confirmation will be sent out. Our coordinator will be in contact with you about all the necessary information.

Cancellation and Refund Policies


Spanish for Medical is an independent broker for language programs. Spanish for Medical cannot be held liable for the actions of said schools.

We will attempt to make every effort to assist students to resolve any issues that may occur between schools and themselves. Our goal is to ensure that students have a positive experience.

Furthermore, Spanish for Medical is also not liable for personal injury, property damage or loss occurring while attending these institutions. Spanish for Medical is not a travel agency and all matters of reimbursement, refund, or change of program while in school must be dealt with between the student and the school or agency.

If a student changes their mind prior to travel during the first week after sending in their deposit and decides that they do not want to participate in the program:

Before six weeks prior to travel, Spanish for Medical will refund 100% of the deposit minus a $50 dollar administrative fee.

After three to six weeks prior to travel we will refund 60% of the deposit.

The final two weeks prior to travel we will refund 50%.

Once the program has begun there is NO refund of the deposit.

If you combine two or more sites to create a multi-country/city program, no money will be refunded once the first program has begun. If you cancel a program due to a personal emergency and you cannot continue with the program, all matters must be dealt with the school itself. There is not refund on all deposits.

The above refund policy is exactly the same in cases of cancellation due to war, terrorism or similar cases. Programs can get canceled and/or changed, Spanish for Medical is not responsible for these changes. Spanish for Medical's liability is limited to only money paid for the deposit. Remaining balance must be dealt with the school.

Please observe the local holidays, classes maybe or will be cancelled, therefore it will not be made up and are not subject to any refund.

Need Changes to the Program?


It is possible to change your start date at anytime. But, all changes within two weeks of the scheduled start date are subject to an additional $25 fee. If you have started a multi-country/city program, you may not cancel or substitute locations but you may be able to change the start dates for a $25 fee.

Arrival and Departure Information


Almost all the programs suggest you arrive at the location a day before the class starts. This is to ensure the student is partially oriented on the program. Students staying with Host Families can meet and greet and get situated at their lodging place. Some special programs offer more options from tours or extended length of time with host families. In this case students may need to arrive several days prior to class start. All additional activities are additional payments. Ask our coordinators about these Special Programs (depending on country/city).

Disclaimer of Liability


Spanish for Medical is an independent broker and is not liable for any risks you may encounter. You may be exposed to certain risks, while participating in these programs. These exposures include, but are not limited to accident and/or sickness without readily available medical facilities, the forces of nature, travel in the air, travel on the ground, terrorism, and war. By filling out the registration form and sending it in to Spanish for Medical you are declaring that you have read and agree to this statement as written and intended. You are also agreeing to indemnify Spanish for Medical Unlimited, and its employees harmless for any and all liability that may arise in connection with your participation in Spanish for Medical programs outside of the United States.

 

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