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CEPE / Registration Form / Guadalajara

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Registration Form

Consult the CEPE calendar and fee schedule to select sessions you wish to attend.

Please note the respective application deadline

If you are submitting your application online please complete the application form as follows, you will then be given an opportunity to pay $150 registration fee with a credit card. Please take note that this fee is Non refundable . You will be expected to complete payment for all services upon arrival.

Note: Admissions remains open until the start of each session.

You will receive an official e.mail notification of acceptance two to three weeks after CEPE has received your application and registration payment online. We will include notification of housing if requested.

A PDF version of the form is available for those who do not wish to apply online

You may also choose to mail the fee to the admissions office, but we cannot process your file until the fee has arrived. We will send you a written confirmation that your application has been received. Please take note that regular mail will take three to four weeks to arrive.

General Information
First name
Middle name
Last name
SexFemale Male
Date of birth DD/MM/YY
Place of birth
Mailing address
City, State(Province), ZIP  
Country
Telephone
Fax
E-mail
Where are you currently enrolled at?

if not in the list, write your school's name here:
Current level / knowledge of Spanish:
None Beginner Intermediate Advanced
Indicate sessions (s) to which you are applying:
Five-week session
Winter I Winter II
Spring I Spring II
Summer I Summer II
Fall I Fall II Fall III
How many hours are you planning to take (one class=two hours)
Two-weeks sessions
Winter A Summer A
Summer B Summer C
Fall A
Academic sessions
Spring quarter Spring semester Fall quarter
Winter quarter Fall semester Academic year
Seven weeks Two cities
One to one
From
To
Hours
Specialized programs, which one?
Will you study to earn credits? Yes No
Where did you found CEPE ?
Publication, which one?
School, which one?
Internet, http://
Other:
Contact in case of emergency: name and telephone
Information for homestay placement
I want to lodge in with a family:
single room double room
I prefer a host family:
with children without children no preference
with pets without pets no preference
smoking Non-smoking no preference
I want to lodge at the CEPE Bed & Breakfast:
I prefer lodging in:
single room   double room 
I do not require lodging and I will arrange housing on my own  
Payment method:
Registration fee
 150 USD
Visa  Master Card  PayPal 
Credit card number
Ex. 1234-5678-9012-3456
Expiration
Name of card holder
I certify that the above information is true and correct. If admitted,I agree to abide by all regulations established by CEPE. By signing this document, I agree to pay the total amount stated by myself, and authorize CEPE to charge my credit card.
Tomás V. Gómez 125 Colonia Ladrón de Guevara 44600 Guadalajara, Jalisco México Telephone ++52 33 36 16 43 99 Fax: ++52 33 36 16 40 13