IPSA - International Partners for Study Abroad
Application
to Spanish Language School in Granada, Spain
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
1746 E. Winchcomb Dr.
Phoenix, AZ 85022, USA
or by Fax to: +1 (602) 942-6734
Program Starting Dates and Application Deadlines
You may start your classes ANY MONDAY year-round if your level
of Spanish is elementary through advanced! Courses for beginners also
start on Mondays, but only two times a month.
Normally, we must receive a complete set of application
documents and fees no later than 21 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?
Standard or Intensive Course
Please check one of the following courses:
__A Standard Course __B1 Intensive Course __B2 Superintensive Course
__C1 Standard Plus 1 __C2 Standard Plus 2
Examination Course
Please check one of the following courses:
__C1 Preparation Course Standard-Plus 1
__C2 Preparation Course Standard-Plus 2 __Examination Course D.E.L.E.
"Uno a Uno" Individual Courses:
General Spanish, Business Spanish, Courses for Teachers of Spanish
Please check one of the following courses:
__D Individual / General Spanish __D Individual / Business Spanish
__E Training Course for Teachers of Spanish
Please check the number of private lessons per day: __3 __4 __5 __6
Cultural Course:
you may register for these courses in addition to other selected courses
Please select one of the following courses:
__Spanish Culture and Society __Spanish and Latin-American Literature
__Spanish and Latin-American MusicS __panish Films
I Wish to Start Classes on ___(Day) _____________ (Mo) ______(Year)
For how many weeks do you want to register: ____Number of weeks
I will arrive on ________________________________ (Day-Month-Year)
What is your present level of Spanish?
__Beginner __Elementary __Low Intermediate __Intermediate __Advanced
Accommodations:
I want my accommodotions to begin on ____________-______-_____(MM-DD-YY)
and finish ____________-______-_____ (MM-DD-YY) for a total of ___weeks
Please select the accommodations you prefer:
__A. Private Accommodation with use of kitchen facilities in shared flats
with Spanish people: __Single room __Double room
__B. Private Accommodation with use of kitchen facilities in shared flats
with other foreign students: __Single room __Double room
__C. Host family accommodation with breakfast, half board or full board:
Single room with: __breakfast __half board ___full board
Double room with: __breakfast __half board ___full board
__D. Student Residence with breakfast, halfboard or full board:
Single room with: __breakfast __half board ___full board
Double room with: __breakfast __half board ___full board
__E. Hotel. Room with bath/shower/TV/phone: __Single room __Double room
__F. Hostel. Room with bath and shower: __Single room __Double room
__G. Apartment. Self-catering apartments with kitchen, bathroom, 2 double
rooms, for 2-4 people; bed linen is provided, but not towels
Part C. Payment of Fees:
Please note that your application will be considered only when your
payment of the non-refundable Application Fee of 60 USD and the Tuition
Deposit of 200 USD has been received.
All payments must be made in U.S. dollars and payable through U.S. banks.
Any collection charges will be the applicant's responsibility. Checks or
international money orders drawn on foreign banks will not be accepted.
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
1746 E. Winchcomb Dr.
Phoenix, AZ 85022, 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 the application
fee and the tuition deposit at the time of accepting your application and
will process the payment of the balance to your credit card only after
registering you for the course. Please also note that if you would prefer
to pay the balance by credit card, a 4.5% payment processing service fee
will be included in the invoice.
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
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 have read the
Agreement and agree to follow all IPSA and study abroad host procedures. This
Agreement will be effective when my application is accepted by IPSA and shall be
governed by the laws of the State of Arizona, USA.
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.
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