1. Full Name (nombre)
2. Country (país)
3. Address, phone, email (dirección, teléfono, e-mail)	phone: email: please check that you have entered your correct email address!
4. Emergency Contact Name, Address, Phone (contacto emergencia nom., dir., tel.)
5. Identification (identification)	M F Age (edad) Height (altura) Hair (pelo)
6. Profession (profesión o carrera)
7. Spanish Level (nivel de español)	Beginner Advanced Beginner Intermediate Advanced
8. Years of Spanish Study (años estudios español)	years of study years since last year of study What languages do you speak?
9. Weeks of Study at SSS (fechas de estudiar)	Start date (Sun) End date (Sat) # Weeks of study
10. Tuition Fee (for classes and activities) (precio semanal)	1 week - $230 2 weeks - $430 3 weeks - $615 4 weeks - $800 More at $190/ additional wk
11. Extra Tutoring (tutoría extra)	None 1 hr/day 2 hrs/day 3 hrs/day 4 hrs/day
12. Homestay (alojamiento con familia) with private room and food, price included in tuition fee.	Homestay Yes No - deduct $60/wk Extra homestay required? No Yes $15/day
13. Dates of Extended Homestay (if applicable) (alojamiento extra)	# days #weeks dates:
14. Special Comments, Interests or Homestay Preferences (pref., dieta/aloj, intereses)
15. Transportation from Airport (servicio de transporte) *$70 is for one-way only. For service back to the Airport, you will be charged an additional $70.	Yes -- $135 (round trip) No Date and time of arrival Flight number and airline
16. How did you find out about us?
Registration (free!)	$
Tuition Fee (line 10)	$
Extra tutoring (line 11)	$
Homestay (line 12 + 13)	$
Transportation fee (line 15)	$
No homestay (subtract $60/wk from total)	$
Credit/Tax	$
Total Cost	$

SSS Registration, Payment and Cancellation Policies
1. Registration:
Children under 18 must be accompanied by a SSS registered adult or submit the SSS Parental Agreement Form with their application. SSS registration fee pays for all processing and program administration and is non-refundable . Your registration is valid for futher SSS program services for 12 months after your program start date (the first day of services, lodging or classes). SSS may, at its own discretion, without obligation of refund or other compensation, temporarily or permanently deny service to students who behave in a manner that SSS deems incompatible with a civil and respectful school or homestay environment.

Menores de 18 años deben ser acompañados por un adulto inscrito en el programa de SSS o deben entregar el SSS Parental Agreement Form con su formato de inscripción. La tarifa de inscripción paga la administración del programa y no es reembolsable. Su inscripción es válida por 12 meses a partir de la fecha del inicio de su programa (el primer día de clases, alojamiento, o servicios). SSS puede, por su propio juicio, sin obligación de reembolso u otra forma de recompensa, temporal o permanentemente denegar servicio a un alumno que se comporta de manera que SSS estime ser incompatible con un ambiente civil y respetuoso en la escuela o el alojamiento de familia.

2. Payment deadline and method:
Payment in Nicragua can be made in US cash, traveler's checks, Visa/Mastercard, or personal check with no payment deadline.

Se puede pagar en Nicaragua en efectivo dólares o por medio de tarjeta de credito, cheque de viajero, cheque personal o Visa/Mastercard sin ninguna fecha tope.

3. Cancellation/Change/Refund Policy:
Registration and bank transfer fees are non-refundable. Requests for program changes are processed by cancellation and re-registration and are subject to these cancellation policies. Cancellation for refund or program change credit made two weeks or less (four weeks for groups) before your program start date receives refund/credit of tuition and service fees less 50% of the value of one full program week´s tuition/lodging amount. Cancellation with request for refund, received on or after the program start date, receives a refund equivalent to 50% of tuition/lodging fees for each remaining full week of your program. Cancellation with request for program change, received on or after the program start date, receives a program change credit equivalent to 75% of tuition/lodging fees for each remaining full week of your program. Program chagne credit is non-transferable and must be immediately applied to subsequent SSS registration for program change or extension; otherwise, only 50% refund will be authorized. Cancellation with request for refund or program change credit must be submitted in writing and received by SSS by 12:00 noon of the Saturday before the following week(s) to be cancelled, to be eligible for refund/credit. Refunds may take up to four weeks to process.

La tarifa de inscripción y de transferencia bancaria no son reembolsables. Solicitudes de cambios de programa se procesan por medo de cancelación formal y nueva inscripción y son sujetas a estas políticas de cancelación. Cancelación de su programa pidiendo reembolso o crédito más que dos semanas o menos (cuatro por grupos) antes de la fecha de inicio de su programa recibe un reembolso o crédito del costo del programa menos 50% del valor de una semana completa del programa. Cancelación con solicitud de reembolso, recibido en, o después de, la fecha de inicio de su programa, recibe un reembolso equivalente de 50% del costo de cada pendiente semana completa de su programa. Cancelación con solicitud e cambio de programa, recibido en, o después de, la fecha de inicio de su programa, recibe un crédito para cambio de programa equivalente a 75% del costo de cada pendiente semana completa de su programa. Crédito para cambio de programa no es transferible y debe ser aplicado inmediatamente a una inscripción de SSS por cambio o extensión de programa; de otra manera solamente el reembolso de 50% será autorizado. Cancelación de programa con solicitud de reembolso o crédito para cambio de programa tiene que ser comunicado por escrito y recibido por SSS al más tardar el mediodía del sábado antes de la(s) semana(s) por ser cancelada(s), para calificar por reembolso o crédito. El pago de reembolso puede dilatar hasta 4 semanas.

I, the undersigned, understand and agree to the terms and policies of this contract as described on this appliation form. I agree not to hold SSS, its school, agents, or employees liable for any injury or loss that I or my property may experience during the course of my travel or Spanish school program, activities, or homestay. I am in good enough physical/mental/emotional health to adapt to the challenge of travelling and living in a foreign environment and culture. I agree to act with civility and consideration toward my fellow students, SSS personnel, and the native populations with which I will be in contact during the duration of my program and homestay.

Yo comprendo y acepto los términos y las políticas de este acuerdo como explicados en este formulario. Acuerdo no responsabilizar a SSS, a sus agentes o empleados por cualquier daños o pérdidas que yo o mi propiedad pueda sufrir durante el transcurso de mis viajes o programa de estudios de español, actividades, o alojamiento con SSS. Tengo suficiente salud física / mental / emocional para adaptar a las exigencias de viajar y vivir en un ambiente y cultura extranjeros. Acuerdo comportarme con respeto y consideración hacia mis compañeros de clase, el personal de SSS y la gente nativa con que esté en contacto durante la duración de mi programa y alojamiento.