Book Now - ViaSpanish - Spanish Courses Abroad

Please keep in mind that this booking form will be forwarded to our partner Spanish school in Buenos Aires who will then respond to students.

Personal Information

First Name: *
Last Name: *
Email: *
Gender: *	Female Male
Date of Birth: *
Home Telephone: * (please include country and area code)
Mobile Telephone:
Work Telephone:
Address: *
City: *
State/Province: *
Zip / Postal Code: *
Country: *
Nationality: *
How did you find us?: *
I found ViaSpanish through: (please be specific)
Passport Number: *
Profession / Field of Study: *
Work Status: *
Alternative Email:
Native Language: *
Other Languages Spoken: *

Emergency Contact Details

Last Name: *
First Name: *
Address: *
City: *
State / Province: *
Zip / Postal Code: *
Country: *
Nationality:
Language Spoken: *
Home Telephone: *
Email Address: *
Alternate Telephone:
What is your relationship with this person?:

Additional Information

Interests, Expectations, Comments:

Program Information

Spanish Level: * (an approximate idea of your Spanish level is all that is needed; a test will be sent to confirm your exact level)
Select a Program: *
Number of Weeks: *
Course Start Date: *
Need an additional program?

Select a Program:
Number of Weeks:
Course Start Date:

Accommodation Details:

Select your accommodation in Buenos Aires:
(optional)

Select your workshop in Buenos Aires:

Fileteado Workshop:
Polo:
Tango Workshop:

Select your services in Buenos Aires:

Airport Pickup U$D 55.00

Please make sure to provide your estimated arrival time, with special attention to indicating AM/PM or 24 hour clock

Estimated Arrival Time:
Departure City:
Flight Number:
Airline:
I wish to share my pick up with: (maximun 3)

Terms and Conditions

By ticking the box labeled "Yes" I agree to the Terms and Conditions of ViaSpanish and declare the above information to be true. I understand an invoice for program fees will be sent to me shortly after my registration has been received and that my registration will not be completed until the proper payment has been received.

YES

Check In Date: (one week minimum for homestay and shared apartment, one week include 7 nights)
Check Out Date:
Check Out Date:
Allergies / Special Dietary Needs / Special Needs:
Are you Smoker?:	Yes No
Do you mind living with children?:	Yes No
Do you mind living with pets?:	Yes No
Do you mind living with smokers?:	Yes No
I am part of a couple requiring a shared bedroom:	Yes No

Booking Form