Pura Vida Language School - Learn Spanish in Costa Rica

the learning/adventure experience in manuel antonio, costa rica

Print this form, fill in all required fields, and mail to Massachusetts address with a $100 deposit of a teller’s, cashiers, or personal check made out to “Pura Vida Language School”.
Fill out the on-line registration for all required fields, including credit card authorization for a $100 dollar deposit.

Name:
Street address:
City:
State:
Zip:
Country:
Telephone:
Email:
Age:
Sex:	Male Female
Start date:	(YYYY-MM-DD)
End Date:	(YYYY-MM-DD)
Homestay:
Will you require extra homestay days?
How many before start date:
How many after end date:
Where did you learn about us:
Flight Information: (Flight information is not required. However, it is important to know when we will need to pick you up and to notify your host family.)
Date of arrival:	(YYYY-MM-DD)
Flight number:
Time of arrival:
Last airport before landing in San Jose:
Aproximate language level:
Do you have any special requirements? (Physical disabilities, dietary needs, etc.)