For additional information: spanish@mesoamerica.org

   Please print and mail the pdf form

Mesoamerica Institute Registration Form                           ABROAD Payment and/or Registration Check  (payable to "Mesoamerica Institute") Credit card: (Please call to charge by phone) Amount included  Reservation fee $100 (towards full payment)   Payment for classes           Amount :________   Program: ____________ Personal Information   Name       Address             City     State     ZIP       Phone (Home)     Phone (Work)     Cell     e-mail             Program   Please enroll me in the following programs:   My Spanish/Portuguese is: Beginner Fast Beginner Advance Beginner Low Intermediate Intermediate High Intermediate       Core Program Starting Date Mon/Wed      9:00am-10:30am                           10:30am-Noon Tue/Thurs    5:30pm-7:00pm                           7:00pm-8:30pm                           Saturday                                10:00am-1:00pm Another time: Two Week Intensive Starting Date: 9:00-12:00pm 1:00-4:00pm 6:00-9:00pm Month Long Starting date: 9:00-12:00pm  1:00-4:00                  6:00-9:00pm How did you find out about us:     Express   Website search   Word of mouth  Other: _________________