León Spanish School of NicaraguaLSSN Individual registration form

Student Name:
Number and passport country:
E-mail:
Address and Phone:
Emergencies Contact:
Sex:
Age:
Profession or Career:
Spanish speaking/listening ability:	Beginner Beginner Advanced Intermediate Advanced
Spanish writing/reading/grammar ability:	Beginner Beginner Advanced Intermediate Advanced
Previous Spanish Studies:
Program	1 week: $140.00 2 weeks: $260.00 3 weeks: $375.00 4 weeks: $480.00 5 weeks or more: weeks x $115.00 Extra Individual Tutoring: U$8.00 X hora
Lodging options:	1 week: $84.00 2 weeks: $160.00 3 weeks: $230.00 4 weeks: $300.00 Days of extra Lodging: U$14.00 x (1-5) days = $___ Extra Lodging Weeks: (1-15) week x U$84.00 = $___ Other
How did you hear about LSSN?