Please don’t forget to include 2 passport-size photos with your name.
Staple here .
(PLEASE PRINT CLEARLY USING BLOCK LETTERS)
__________________________________________________________________________________
First Name Last Name
__________________________________________________________________________________
Address
_________________________________________________________________________________________________________
City State/County Postal Code (ZIP)
__________________________________________________________________________________
Country Nationality
__________________________________________________________________________________
Telephone
Date of birth: __________________________
Email
Passport number: ____________________________
Emergency contact info: _________________________________________________________________
(PLEASE PRINT CLEARLY USING BLOCK LETTERS)
FOR STUDENTS ONLY
_______________________________________________________________________________________
Name of your University School’s location (city, state/county, country)
_______________________________________________________________________________________
Name of your most current Spanish professor His/her phone number and/or email address
_______________________________________________________________________________________
Level of Spanish you’ve most recently completed Number of years you’ve studied Spanish at the university
Level of Spanish (please check one)
 Beginner. Fair understanding of basics; can speak in simple statements.
 Intermediate. Can write short sentences and participate in a basic conversation.
 Advanced. Can write complex sentences and participate in all conversations.
 Superior. Your Spanish – both in written content and in spoken content and accent - is nearly like a native’s.
(PLEASE PRINT CLEARLY USING BLOCK LETTERS)
FOR STUDENTS ONLY
Please list here above any special dietary needs, such as ‘vegetarian’ or ‘food allergies’ (please specify).
Do you have other allergies (cigarette smoke, pets, etc.)? Please specify here above.
If you are taking any medication, please specify here above. Additional medical information?
Normally students live in pairs or triples. If you would like to share a host-family room with a friend (same sex only), please write his/her name here above.
Passport photo
1
Passport photo
2

Price: $3,500
Dates:
 May 31 – July 11, 2009
*Application deadline: April 23, 2009
 May 30 – July 10, 2010
*Application deadline: April 22, 2010
Price: $3,000
Dates:
 May 31 – June 27, 2009 (Session I)
*Application deadline: May 1, 2009
 June 28 – July 25, 2009 (Session II)
*Application deadline: May 1, 2010
Price: $8,000
Dates:
 September 2 – December 19, 2009 (Fall
Semester)
*Application deadline: June 5, 2009
 January 20 – May 22, 2010 (Spring
Semester)
*Application deadline: October 23,
2009
 September 1 – December 18, 2010 (Fall
Semester)
*Application deadline: June 4, 2010
Price: $8,000
Dates:
 September 6 – December 19, 2009 (Fall
Semester)
*Application deadline: June 5, 2009
 January 21 – May 22, 2010 (Spring
Semester)
*Application deadline: October 23,
2009
 September 5 – December 18, 2010 (Fall
Semester)
*Application deadline: June 4, 2010

Medical and Accident Insurance
Our included Medical and Accident
Insurance covers hospital bills, doctors’ fees and medical transportation up to 30,000€ for illness and/or injury sustained by a student during the program in Spain. In addition, this insurance covers transportation, food and lodging expenses during 10 days for one relative of the patient to be at the patient’s side in the event of a lifethreatening illness or injury that requires hospitalization. The Medical and Accident Insurance also covers the costs for the transport of an injured or ill participant to an adequately equipped hospital, or to a hospital in the participant’s country of residence.
Program Interruption Insurance
Our included Program Interruption
Insurance covers the transportation costs (provided that the originally included-transport cannot be used) for a participant to interrupt his/her
MundoLengua program to fly home to his/her country of residence in the event of the death of a family member, or in the event of severe damage to the participant’s home or business.
 Yes, I want the optional insurance with the extra cost of 31,50€ per week.
 No, I do not want the optional insurance.
For non-US students only. US students have insurance included in most cases.
General
 The total program price (less deposit) is due 6 weeks prior to the course start-date.
 All bank charges are the responsibility of the student and/or parent/guardian; if the bank (originating or receiving) charges MundoLengua a commission, MundoLengua reserves the right to charge this sum to the student.
 MundoLengua reserves the right to cancel a student’s place if, on the day of his/her arrival, he/she has not paid the total program price.
Regarding Accommodation
MundoLengua Centro Internacional de Español will be herein referred to simply as ‘MundoLengua’.
 The student will be charged for the replacement of items broken due either to negligence or intention on the part of the student.
 The student may be charged for the replacement of locks if the host family’s keys are either lost or stolen due to negligence on the part of the student.
 Neither students nor chaperones will have the right to a refund for any portion of unused housing, for any reason.
Regarding Expulsion
 In the case of a serious disciplinary offense, or infringement of one of the Program Rules
(see next page), MundoLengua reserves the right to expel the student from the program
(both school and accommodation components) without any refund of unused portions and/or components of the program. The student will also be responsible for any fees associated with the return to his/her home country.
 Students are also responsible for the cost of damages caused to third parties as a result of student infringement of the Program Rules (see Program Rules, next page).
Regarding Cancellations
 If the student cancels from the program after payment of the deposit, but 6 weeks or more prior to the program’s start, MundoLengua will refund him/her all monies paid less applicable transaction costs.
 If the student cancels from the program on a date that is 6 weeks or less to the program’s start, MundoLengua will refund him/her all monies paid less the deposit.
 If the student cancels from the program on a date that is 2 weeks or less to the program’s start, MundoLengua will refund him/her 50% of all monies paid.
 No refunds will be paid once the program has started.
I certify that I have read, understood and agree to the terms put forth in these Program Conditions, as well as the Program Rules (next page) which
I must follow as a participant in a
MundoLengua program.
Signature,
___________________________
Date
I agree that if I, ________________________________________________, become ill or have an accident, MundoLengua or its representatives (including group coordinators, host parents or accompanying professors) may take such action as they consider necessary to secure medical treatment, including the administration of an anasthetic and surgery.
Liability Release
I hereby release MundoLengua, its officers, Board of Directors, representatives and agents from any and all claims, charges, costs and/or causes of action – whether covered by insurance or not - for loss of property, personal injury, illness, accident or death sustained by the participant during the MundoLengua program.
Further Points
I understand that MundoLengua’s future publicity materials may include statements made by participants or their photographs, and I consent to such use of my son’s/daughter’s comments or photographic likeness.
Misrepresentation Clause
If I have personally misrepresented, or have knowledge of misrepresentation of any portion of this application, I understand and agree that MundoLengua has the option of immediately dismissing the participant from the program, and sending the participant home. In the event that I am sent home in such a case, I understand that I bear all the costs incurred and that the program fees are non-refundable.

1.
Students will respect and uphold family rules regarding curfew. Activities such as inviting guests to the host family’s home, smoking inside the home, use of the family’s telephone, and, if applicable, use of the family’s Internet, must be approved by the family.
2.
Students will not drive cars, motorcycles or scooters at any time during the program. In order for a student to drive any off-road motorized vehicle, written permission must be obtained from parents or legal guardian.
3.
Hitchhiking or soliciting a ride from a stranger is prohibited.
4.
A student may not enter into any kind of contractual arrangement, be it business, religious or marital.
5.
Students must take responsibility for all personal property; MundoLengua cannot be held responsible for any student’s personal property that is lost or stolen.
6.
Students will not discuss their host family’s private affairs with anyone other than a
MundoLengua representative.
7.
Students cannot change their host family without permission from a MundoLengua representative.
8.
Students must obey all local and national laws.
9.
Use of illegal drugs, or association with anyone involved with illegal drugs, will result in the student being returned to his/her home country, without recourse and at the student’s expense.
I certify that I have read, understood and agree to the Program
Rules listed above.
___________________________________________
Signature, student
_______________________________
Date
I have included my deposit:
with this application.