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• Evening telephone number (Area Code):

• Fax number (Area Code):

• E-Mail Address:

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• Occupation:

• Age:

• Level:

• How long are you going to study at Becari:

• Date you wish to start:

• Program: Regular Intensive Super-Intensive Private Group

• Do you need accommodation?: Family Apartment Hotel

• Date of your arrival:

• If you want to live with a local family in Oaxaca, please check the boxes according to your needs:

• Do pets bother you? Yes No

• Smoking? Yes No

• Children? Yes No

• Do you have allergies? Yes No

• Do you have special dietary needs: Yes No

• Breakfast only: Yes No

• Breakfast and lunch: Yes No

• Breakfast, lunch and dinner: Yes No

• Do you want to be the only student staying in the house? Yes No

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