Complete the form below to enroll with Celas Maya. This page is secured using
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All fields are required.

Identifying Information


Enter your full name:


Street Address:


City, State/Province, Postal code:


Country:


Nationality (if different)
:


Date of birth:
Day: Month: Year:

Phone number:


E-mail address:

Profession/Occupation:


Requested study start date (ex. 3 April 2005)


Planned weeks of study:

Additional Information

Language you will study:
Spanish Quiche / K'iche Spanish on-line Quiche / K'iche on-line

Additional Activities / Optional:
Spanish & Volunteer Volunteer work only Volunteer work & Host family (No Spanish classes) Salsa & Spanish In case of volunteering: please specify the organization of interest,
time available and your (expected) Spanish level.�


In case of the combination of Spanish classes and Salsa classes:
please specify the style of interest and the amount of hours for
Spanish classes.�



Describe any previous experience with this language:

Describe any special areas of study on which you want to
concentrate
:

Describe any preferences concerning your family homestay; e.g.
pets, children, smoking
:

Describe any special dietary requirements:

Describe any allergies or medical conditions of concern:

Please provide emergency contact information. At a minimum,
include name, telephone number, and relationship
:

1.How did you find out about Celas Maya:
Google 123Teachme Xelapages Other web site

2. What can we do to make our website more informative/easier to
use
:

Credit card information.
When you will be studying at Celas Maya, a non-refundable registration fee applies. This exists of $30, plus $3 of processing fee ($33 in total).
Please note that at this time we can only accept payment by VISA -- we cannot
accept MasterCard or American Express. 

For other payments like online classes, this registration fee of $33 does not apply. For these payments, a processing fee of  8% applies.

Name on VISA card:
Billing phone number:

Card number:

Expiration Date (e.g. 11/05):


Celas Maya process this form by means of staff and not computers. This is why you do not need to add your 3/4 didget security number.

For students using MasterCard, American Express or students interested in saving the $3.00 processing fee you can sign up using the link below paying only $30.00. https://guatepay.com/reg_celasmaya.htm





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If you are not comfortable with enrolling online, you may fax us the printable form at 502-7761-4342