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Registration Form
To register for a Spanish course (and volunteer position) please complete and submit the following information:
Personal Information
First Name: * Last Name: *
Date of Birth: (dd/mm/yy) * Profession / Occupation: *
Mother Tongue: * Country: *
Mailing Address: *
E-mail Address: *
Phone: * Fax:
Cell phone: (include country code and area code)
* required fields
Language Course
Spanish Course | One-to-one Course Minigroup (2-6 people) | Standard (20 h./week) Intensive (30 h./ week)
Three Months Peru intensive (Spanish language classes + volunteer work) Details (please complete volunteer section below)
One to One D.E.L.E. Preparation Standard (20 hours per week) Intensive (30 hours per week)
One to One Quechua Course Standard (20 hours per week) Intensive (30 hours per week)
Date
From to (dd/mm/yy)
What is your Spanish Level?
Beginner Elementary Intermediate Advanced None *
Accomodation in Cusco (for hotel reservations, please, look at our general information page) *
Host family / Homestay
From: (DD/MM/YY) to: (DD/MM/YY)
As you have chosen to stay with a Host Family, please complete the following questions:
Vegetarian? Yes No
Other dietary needs? Yes No , Please indicate
Allergies? Yes No , Please indicate
Smoking okay? Yes No
Pets okay? Yes No
Children okay? Yes No
Please indicate anything else regarding your homestay, ie: sharing or not sharing room, location, etc…
Hostel: SR DR
Hotel (3 stars) SR DR
No accomodation
Cusco Arrival
If you have not yet booked your flight, would you like Acupari to book your Lima to Cusco flight? yes no *
For the following date: (dd/mm/yy)
At the approximate time: (from 06.00 – 15.00, after that, there's no flights to Cusco)
Passport Number:
If you have already booked your flight, for your airport pickup in Cusco, please indicate your arrival information:
Arrive in Cusco:
Date (dd/mm/yy) Time: AM PM
with (Airline)
If you still don´t have your flight information to Cusco, please send it at a later date to amy.bakal@acupari.com
Accomodation in Lima:
Would you like Acupari to arrange your hotel with transfer in Lima? yes no *
From: (dd/mm/yy) to: (dd/mm/yy)
Arrive in Lima:
Airport tranfer to and from hotel-airport is included.
Date: (dd/mm/yy)¦ Time: AM PM
with (Airline)
Volunteer or Practicum: yes
If you are interested in volunteering, please complete the following section
I am volunteering to earn credit for a practicum. yes no
Duration of volunteer position? (minimum of 2 weeks)
From to (dd/mm/yy) (Most volunteer positions begin on a Monday)
Why do you want to volunteer?
Qualifications and skills:
Location?: Please see our list of institutions
Do you have a criminal record?: yes no
Do you have any health or other problems which might affect your ability to volunteer?: yes no
Volunteer applicants are responsible for their own housing. As a service to you, accommodation for the volunteering period can be organized by ACUPARI at reasonable prices.
Other information:
If there is anything else that we should know about you, please indicate in the space provided below:
Promo Code:
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