Learn Spanish in Mexico - San Miguel de Allende

Name:

Address:

City:

State:

Postal Code:

Country:

Telephone:

FAX:

Email Address:

Birthdate:

(dd/mm/yyyy)

Gender:

Female Male

Occupation:

How did you hear about AHA?:

Wich do you think is your Spanish level?

Beginner Intermediate Advanced

Starting Date:

(dd/mm/yyyy)

Ending Date:

(dd/mm/yyyy)

Classes:

Intensive	Semi-intensive 4hrs.
Semi-intensive 3hrs.	Private Classes

Housing:

I'll make my own arrangements
I would like to live with a Mexican family

Single or Double:

I want a private room
I will share a double room

Arrival Date:

(dd/mm/yyyy)

Departure Date:

(dd/mm/yyyy)

Name of Roommate:
(If you have one)

Please list any special needs you have:
(i.e. diet, allergies,
non-smoking, etc.)

Completing Your Registration Online:
In order to finalize your registration, AHA requires a one-time non-refundable Enrollment Fee of $50.00 USD. Please fill in your details below:

Total Amount:

$50 Enrollment Fee

Credit Card:

VISA Mastercard

Name on Credit Card:

Credit Card Number:

Exp. Date (mm/yyyy):

Security Number: (4 digits)

If you prefer to fax this information, please dial: + 52 (415) 152-2333

Please complete the form below and press the "submit" button. Or print and fax to: +52(415)152-2333
Then click the "back" button in your browser window to return to the AHA web site.

Please complete the form below and press the "submit" button. Or print and fax to: +52(415)152-2333 Then click the "back" button in your browser window to return to the AHA web site.

Please complete the form below and press the "submit" button. Or print and fax to: +52(415)152-2333
Then click the "back" button in your browser window to return to the AHA web site.