INFORMATION ABOUT THE
COURSE PARTICIPANT
First name
*
Last name
*
Email
*
Please, re-enter email (for verification)
*
Your country of
residence
*
ABOUT THE COURSE
Location of your choice
(you can choose several locations)
*
Target language (language you want to
learn) *
Select one
Spanish
Dutch
French
German
English
Program of your choice
*
IMMERSION
PROGRAMS
INDIVIDUAL
[ ? ]
A
LA CARTE [ ? ]
DUO [ ? ]
WEEKEND
[ ? ]
PROFESSIONALS' PROGRAM [ ? ]
LANGUAGE VACATIONS
SPANISH
+ DISCOVER MEXICO
[ ? ]
SPANISH
+ DISCOVER SPAIN
[ ? ]
SPANISH
+ COOKING [ ? ]
SPANISH
+ GOLF [ ? ]
When do you want to start your training?
*
Select one
Don't know
October, 2011
November, 2011
December, 2011
January, 2012
February, 2012
March, 2012
April, 2012
May, 2012
June, 2012
July, 2012
August, 2012
September, 2012
October, 2012
November, 2012
December, 2012
After 2012
Number of weeks
*
Select one
Don't know
1 week
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
OPTIONAL SERVICES
Modules
TotalFlex
Module
[ ? ]
& Packages
Exam
Module
[ ? ]
Welcome pack
[ ? ]
Guest plan
[ ? ]
Cross-cultural awareness
[ ? ]
Coaching program
[ ? ]
Online classes (one-on-one)
30
hrs., before the residential course
30
hrs., after the residential course
4 additional classes on Saturday morning (9 AM
to 2 PM)
1st week
2nd week
3rd week
4th week
ACCOMMODATIONS
Room
upgrades
-
Standard Plus
Deluxe
Suite
PLEASE GIVE US SOME FEEDBACK
(OPTIONAL )
Your age group
Select one
18-24
25-34
35-44
45-54
+55
How did you hear about
us ?
Select one
Recommendation
Advert in Magazine
Advert on Google
Advert on Yahoo
Advert on Bing
Search Engine (Google)
Search Engine (Yahoo)
Search Engine (Bing)
About our website:
Is the navigation easy and clear to understand?
YES
NO
Are our services explained effectively?
YES
NO
Any suggestion?
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