AVENTURAS: SANTA CRUZ, CALIFORNIA EXCHANGE PROGRAM REGISTRATION PAGE

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[Image] [Programas de Imersion Inglés en los EEUUImage] [Image]

Educational Travel Adventures

Language and Cultural Immersion Program Consultants

Consultantes En Programas de Lenguaje y Cultura

3565 North Main Street , Soquel, CA 95073 USA

Telephone number in the United States: (831) 476-6360, 8am to 8pm Daily, Pacific Time

Numero de teléfono en los EEUU: (831) 476-6360 de 08:00-20:00, Pacific Time

ADULT STUDENTS MAY USE THIS FORM FOR ELI APPLICATIONS AT U.C.S.C.
TOEFL Scores are not important for acceptance into the program.

Programs for High School Students Programas para estudiantes de la preparatoria	Application Solicitud
For which program(s) would you like to apply? 3- Week Summer Program 10-Week Summer English Intensive Private School Program. Public School Program. Please indicate desired start date and intended length of stay:	Grade Entering Freshman Sophomore Junior Senior

Student Name:

Gender:

Male Female

Date of Birth:

Month / Day / Year

Country of Citizenship:

Address:

City:

State/Prefecture:

Country:

Postal Code:

Home Telephone:

Home Fax:

e-mail:

Name of Father:

Occupation:

Work Phone:

Address:(if different from above)

Home Phone:

e-mail:

Name of Mother:

Occupation:

Work Phone:

Address: (if different from above)

Home Phone:

e-mail:

Have you ever taken a TOEFL test before? Yes No

If yes, what was your score?

How would you describe your English ability in the following areas?

BE SURE THAT YOU HAVE COMPLETED ALL SECTIONS!

Educational Travel Adventures

Language and Cultural Immersion Program Consultants

3565 North Main Street,Soquel, CA 95073 USA
Toll Free (US/Canada): 1 (866) 4-SPANISH (477-2647)
International and Santa Cruz, California area (831) 476-6360

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