IPSA - International Partners for Study Abroad
Application
to Spanish Language School in Barcelona
Please print out this form from your browser,
complete (print or type) and sign the Apllication
and send it by mail to:
IPSA Enrollment Center
40240 N. 69th Place
Cave Creek, AZ 85331, USA
or by Fax to: +1 (602) 942-6734
Application Deadlines
Normally, we must receive a complete set of application
documents and fees no later than 30 days before the program starts.
Part A. Personal data:
First Name: ___________________ Last Name: ______________________________
Home Address: _____________________________________________________________
___________________________________________________________________________
Telephone: (____)________________ Fax: [optional] (____)__________________
E-mail: [optional] ________________________________________________________
Date of Birth: (month/day/year) _____/____/___________ __ Male __Female
Place of Birth (country, city): __________________________________________
Nationality: _________________ Citizenship (country): ___________________
Native language: __________________
Do you need a student visa to study in Spain? __yes __no
Other languages, if any: __________________________________________________
I am a college __ freshman __ sophomore __ junior __ senior
__ Graduate Student __ High School Senior __ Interested Adult
__ Professional. Please enter your profession: _______________________
If you are a graduate or undergraduate student, please provide the
following information:
Current college/university/graduate school: ______________________________
___________________________________________________________________________
Major field of study: _____________________________________________________
Address of your college, university: ______________________________________
___________________________________________________________________________
Emergency Contact:
Name: ________________________________________________________________
Relationship:______________________ Telephone: ________________________
Address: _____________________________________________________________
Part B. Program data:
Which course would you like to study?
Intensive, Superintensive and Spanish for Life Courses
Please check one of the following courses:
__Intensive (1-11 weeks) __Superintensive (1-11 weeks)
__Spanish for Life - 12 weeks and more - Intensive
__Spanish for Life - 8 weeks and more - SuperIntensive
__Spanish Talk
Examination Courses
Please check one of the following courses:
__D.E.L.E.: C.I.E. (26 classes) __D.E.L.E.: D.B.E. A - 40 classes
__D.E.L.E.: D.B.E. B - 60 classes __D.E.L.E.: D.B.E. C - 80 classes
__D.E.L.E.: D.S.E. - 80 classes
__Chamber of Commerce - Business Higher Certificate
Individual Training Course:
Please enter the specialization you would like to study:
___________________________________________________________________________
Please check the number of private lessons per day: __2 __3 __4 __5 __6
Specialized Courses
__Intensive Business
*To obtain the Chamber of Commerce Basic Certificate in Business
it is necessary to attend the course for 4 weeks.
__Curso de Repaso for Teachers of Spanish: __group __individual
Spanish Language Programs for Executives:
__Platinum Spanish Course with 20 mini-group lessons a week
__Platinum Spanish Course with 20 mini-group + 5 private lessons a week
__Platinum Spanish Course with 20 mini-group + 10 private lessons a week
__Platinum Spanish Course with 20 mini-group + 15 private lessons a week
Work Experience Program
__ General Spanish + Internship
__ Business Spanish + Internship
__ General Spanish + Paid Job (Study & Work in Spanish Hotels)
__ General Spanish + Paid Job (Study & Work in Marbella)
If you apply for the Work Experience program, we will also need the following:
1. Resume either in Spanish or English, depending on the student's stronger
language.
2. Short essay (1-2 pages) in Spanish: the student has to focus on the kind
of experience he/she wants to have, what he/she wants to learn what kind
of internship the student wants, and why.
3. Two recommendation letters from former employers.
4. Home campus authorization for those seeking academic credit.
You should apply as far in advance as possible (at least 3 - 5 months in
advance of the language study start date) to allow for all phases of the
enrollment process, document collection, approval and arrangements to be
completed.
I Wish to Start Classes on ___(Day) _____________ (Mo) ______(Year)
For how many weeks do you want to register: ____Number of weeks
What is your present level of Spanish?
__Beginner __Elementary __Low Intermediate __Intermediate __Advanced
Accommodations:
Please select the accommodations you prefer:
Host family accommodation:
__Single room: __with breakfast __half board __full board
__Double room: __with breakfast __half board __full board
Student Flat: __Single room __Double Room
School Residence: __Single room __Double Room
Premium Accommodations:
Premium Homestay:
__ private room with breakfast
__double room with breakfast - for two students arriving together
__private room with half board
__double room with half board - for two students arriving together
__private room with full board
__double room with full board - for two students arriving together
Premium Shared Flat
__ private room (no meals)
__ double room (no meals) - for two students arriving together
__double room (no meals) - for single use
__Premium Private Apartment 1-bedroom (no meals)
__Premium Private Apartment 2-bedroom (no meals)
__Hotel
Please also fill in below:
Are you a smoker? __yes __no
If you have a special diet, please specify:
___________________________________________________________________________
If you have allergies, please specify:
___________________________________________________________________________
If you have other requirements, please specify:
___________________________________________________________________________
___________________________________________________________________________
Part C. Payment of Fees:
A non-refundable application fee of US $80.00, and a tuition deposit of
US $200.00 are required with your application. The tuition deposit is part
of the cost of your course and is deducted from the total tuition fees after
conversion in Euros. The tuition deposit is not an additional cost.
Please note that your application will be considered only when your payment
of the application fee and the tuition deposit has been received.
Upon receiving your application, application fee and the tuition deposit,
we will send you a registration confirmation and invoice for the balance
in Euros converted in U.S. Dollars according to the current exchange rate.
The balance can be paid in U.S. Dollars or in Euro.
The payment of the balance of fees is due upon receipt of invoice.
Your place will be confirmed only when the full payment has been received.
The full payment must be paid before we can issue documentation in support
of a visa application.
You may pay the balance by wire transfer, check or money order, or by credit
card.
Please select one of the following payment options:
1. __Please find enclosed a certified check/money order for the application
fee and the tuition deposit.
Cashiers Checks or international money orders must be made payable to IPSA.
Please send a check or international money order with your application to:
IPSA
40240 N. 69th Place
Cave Creek, AZ 85331, USA
2. International Wire Transfers
You can make your payment by wire transfer. Just fax us your application
and request our account and bank information:
___I want to pay the application fee and the tuition deposit by wire transfer.
Please send me instructions on how to send the wire transfer to your
bank account.
3. Payment by Credit Card:
Please select credit card: ___VISA ___MasterCard
Credit Card No: _____________________ Expiration Date: Month ____ Year_____
Card Verification Value: ___________ (The last three digits on the back of
your credit card after the credit card number.)
Cardholder Name: __________________________________________________________
Street Address: __________________________________________________________
City:______________________ State:___________________ Zip Code:__________
I authorize to charge the above credit card account:
___ application fee and deposit ___ application fee and full payment due
Even if you select a "full payment" option, we will charge only the application
fee and the deposit at the time of accepting your application and will process
the payment of the balance to your credit card after registering you for the
course. Please also note that if you would prefer to pay the balance by credit
card, a 4.5% convenience payment processing service fee will be included in the
invoice. There are no any additional charges on your payment of the application
fee and the tuition deposit by credit card.
Comments: _________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Part D. Agreement and release.
By signing this Application, I certify the above information is complete and
correct. I understand that my misrepresentation may result in my expulsion
from the program. I acknowledge that the terms and conditions appearing on
the Study Abroad International web site constitute part of my agreement with
IPSA and study abroad program host (university, college, language school, or
other institution and/or organization), including sections concerning
responsibility, health, refunds, changes in dates, accommodations, courses
and billing of the selected options; I assume all risks and responsibilities
and discharge IPSA and the study abroad program host and all their officers,
agents and employees from and against any and all claims of damage to
personal property or personal injury which may result from my enrollment and
participation in the study abroad program host courses, excursions, and/or
on and off-campus activities. I have read all terms and conditiones and
rules and agree to follow all IPSA and study abroad host procedures and
regulations. This Agreement will be effective when my application is
accepted by IPSA and shall be governed by the laws of the State of Arizona.
Applicant's Signature ______________________ Date: ___________________
Parent's/Legal Gardian's
Signature if applicant
is under 18 years _______________________ Date: __________________
Please do not forget to make a copy of this completed and signed application
for your records and enclose your payment of the application fee.
|