|
Thank you for choosing ILASO
to study abroad, we will provide
you with best experience in Costa
Rica.
Please complete this form in order
to provide you with the family
that best match your request.
You have two options to send this
form to the ILASO
Office. |
1.
You can complete
it using the bold key to check
in the spaces of Yes or No. After
completing the form you can send
it back by email at info@learningincostarica.com,
a message will be sent to your
email account to let you know
that we receive this form
Please attach one picture of you
and send with the form by email |
2.
Mail to: You can
print this form and mail it to
our ILASO Office at
#SJO 5420
P.O. Box 025331
Miami, FL 33102-5331
Please include 3 pictures of you
(passport size) to this
form |
|
| PERSONAL
INFORMATION |
| Name |
|
| Sex
Male
Female |
| Date of Birth
(mm/dd/yy) |
|
| University or School
|
|
| Email Address |
|
| Mailing Address (No
PoBOx) |
|
| Home Phone Number |
|
| Contact Number |
|
| Other Contact Number |
|
|
| LANGUAGE
PROFICIENCY |
| How longer you have
been taking spanish? |
|
| Please check your
ability to speak Spanish |
|
Poor
Good
Very Goo |
| Please check your
ability to write Spanish |
|
Poor
Good
Very Good |
| Please Check your
Ability to listen Spanish |
|
Poor
Good
Very Good |
| Do you have experience
with foreign languages other than
Spanish? |
|
|
| FAMILY
REQUIREMENT |
| Are you allergic? |
|
Yes
No |
| If yes, please Describe |
|
| Do you like animals? |
|
Yes
No |
| What kind of animals
you like? |
|
| Do you Smoke? |
|
Yes
No
Soc |
| Do you like Children? |
|
Yes
No |
| Do you want to be
the only student at home? |
|
Yes
No |
| Do you want to have
another student hosted in the same
family?, write the name of the student,
please. |
|
Describe
the family you would like to stay
with?, Please include if you would
like a Christian family, with
small children or children your
age, a big family or small one,
with pets or not, for example. |
|
| Are you Vegetarian? |
|
Yes
No |
| Do you need special
dietary while abroad? |
|
Yes
No |
| Describe your diet
please? |
(Please check the food
you can NOT eat) |
|
Do
you have any medical prescription
you need to take while abroad
or medical condition, or special
situation we need to know in order
to fulfill your needs while abroad? |
|
| Please describe you
family background? |
|
| What will be your
goals for this Study Abroad Program? |
|
| Have you been abroad
before?, where and how you like
the experience? |
|
|
HOUSING FORM