Guatemala Spanish Language

IND 4005

SPANISH LANGUAGE

STUDY TOUR

TO

ANTIGUA, GUATEMALA

Applicant Information

I am interested in registering for the Study Tour to Antigua, Guatemala

Name: _________________________________________________________ Gender: M/F

Student ID Number: __________________________________________________

Telephone: __________________________________________________________

E-mail: _____________________________________________________________

Degree level at TC: _____________ Major: _______________________

U.S. Citizen (circle one): Yes / No

Teaching interests: ___________________________________________

Registration preference:

¨ 2 credits

¨ 3 credits

¨ Non – Credit (Please note that $1200 fee will be handled separately)

Registration must be completed to insure availability of instructional and housing accommodations. A non-refundable housing fee of $850 must be paid upon registration.

We are required to ask each of you to provide contact information in case of an emergency:

Name: ____________________________________________________________

Address: ___________________________________________________________

Telephone: _________________________________________________________