UNIVERSITY OF GUANAJUATO

LANGUAGE DEPARTMENT

APPLICATION FORM FOR SPANISH CLASSES

Social Sciences and Hu ani!ies Di"ision Guana#ua!o Ca $us

I% PLEASE CHEC& THE SESSION'S( FOR )HICH YOU )ANT TO *E ENROLLED+

SUMMER COURSE: JUNE SEMESTER COURSE: SPRING

JULY FALL

MONTHLY COURSE (Indicate month):

Please a!!ac, a scan o- .ou/ $ass$o/!0s $,o!o $a1e

II2 APPLICANT PERSONAL INFORMATION

Last Name

First

Middle

Female A e: Male

Nationalit!: Mailin Address: State: E(mail: Phone (incl'de area code): Nati*e Lan 'a e:

"ate o# $irth: (mm%dd%!!) &it!: &o'ntr!: Postal &ode:

Fa): +no,led e o# S-anish: None Poor Fair Good

.o, lon ha*e !o' st'died S-anish/ .o, did !o' #ind o't a0o't o'r co'rses/ 1o'ld !o' need the Uni*ersit! to send !o' an acce-tance letter/ 1hen are !o' -lannin to come/
III2 EMERGENCY CONTACT

Yes

(In En lish

or S-anish

No

Arri*al "ate:

Name:

Relationshi-:

Address: State: .ome Phone:

IV2 HOUSING ACCOMMODATION INFORMATION

&it!: &o'ntr!: 1or2 Phone: Postal &ode:

1o'ld !o' li2e the Uni*ersit! to arran e a home sta! #or !o'/ Yes No I# !es3 -lease #ill o't incl'ded the home sta! -ro ram a--lication #orm4 I# not3 and i# !o' ha*e alread! sec'red !o'r ho'sin 3 -lease -ro*ide details 0elo,: Address in G'ana5'ato: Phone in Gto:

UNIVERSITY OF GUANAJUATO
LANGUAGE DEPARTMENT

APPLICATION FORM FOR HOME STAY PROGRAM

I% PLEASE CHEC& SESSION'S( FOR )HICH YOU )ANT TO *E ENROLLED+

SUMMER COURSE: JUNE JULY SEMESTER COURSE: SPRING FALL

II2 APPLICANT PERSONAL INFORMATION

MONTHLY COURSE (Indicate month):

Last Name

First

Middle

Female MaleNationalit!:

"ate o# $irth: (mm%dd%!!) E(mail: Arri*al "ate: "e-art're "ate: Arri*al 6ime: "e-art're 6ime: Yes No 6rans-ortation: Land Fli ht N'm0er: Air

1o'ld !o' li2e the host #amil! to -ic2 !o' '- at the Leon air-ort/ (Pic2 ( '- ser*ice cost: US789(7:9) Pic3% u$ se/"ice -/o 4+55 AM !o 6+55 PM+ US7859 O!,e/ ,ou/s+ US7:5 1o'ld !o' 0e com#orta0le in a home: 1ith children/ Yes No "oesn;t matter 1ith -ets/ Yes "o !o' smo2e/ Yes No S-eci#! dietar! restrictions3 chronic health -ro0lems3 aller ies or disa0ilities:

No

"oesn;t matter No

"o !o' drin2 alcoholic 0e*era es/ Yes

6o hel- 's -lace !o'3 -lease descri0e !o'r -ersonalit!:

S-ecial -re#erences (not 'aranteed):

I ,o'ld li2e: Sin le occ'-anc! (-ri*ate 0edroom)

PREFERENCE

"o'0le occ'-anc! (shared 0edroom)

"oesn<t matter

1e tr! to accommodate all st'dents3 0't -re#erences are not 'aranteed4 For e)am-le3 i# a st'dent -re#ers a shared room 0't ,e are 'na0le to #ind another st'dent ,ho can share3 the Lan 'a e "e-artment reser*es the ri ht to modi#! !o'r arran ement4
PAYMENT

St'dents m'st -a! their total #irst(month<s #ees ,ithin three da!s a#ter their arri*al in G'ana5'ato4 Prices *ar! sli htl! de-endin on location4 Se es!e/ Su e/;Mon!,l. P/o1/a Sin1le occu$anc. US7=:(=> -er da! US7=?(=@ -er da! T,/ee dail. eals included2 E<ce$! on Sunda.s2 Dou=le occu$anc. US7=C -er da! US7=8 -er da! La'ndr! is NA6 incl'ded4 In the e*ent that !o' reB'ire la'ndr! ser*ices3 one e)tra dollar -er da! ,ill 0e char ed4

*EHAVIOR E>PECTATIONS

All -artici-ants o# the -ro ram are e)-ected to 0e -olite3 res-ect#'l 'ests3 ,ho are tolerant o# di##erent c'lt'res4 Under no circ'mstances ,ill ille al dr' 'se3 cons'm-tion o# alcoholic 0e*era es 0! minors3 or a0'si*e 0eha*ior 0e tolerated4