Universidad Internacional (Uninter)

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Registration - Universidad Internacional (UNINTER)

Please fill in the following registration form:

After getting your registration form, we will immediately confirm the reception of your information. In the case you are not hearing from us within 48 hours, please contact us.

IMPORTANT: A lot of free web based email services (like Hotmail or Yahoo!) and ISP’s (like AOL,…) are offering spam or junk mail filters for their users. A great tool, even though these systems sometimes eliminate serious and important emails. Therefore make sure that you set your email filters in such a way so that you can receive our email messages. ALL our email addresses end with "@EASYMEX.COM"

If you are travelling in company, you only need to fill in one from, if you are registering for the same program and schedule. Please mention only the names with birth dates of the people travelling with you.

Fields marked with an asterisk* must be completed.

PERSONAL DETAILS

Salutation: *
Your First Name: *
Your Last Name: *
Street: *
Number: *
City: *
State: *
ZIP: *
Country: *
Phone: *
Mobile Phone:
Fax:
Your Email: *
Date of Birth: *
Your Nationality: *
Actual Activity: *
Emergency Contact: *	Name / First Name: Relation: Address: Phone: Fax: Email:
Health: (please list any ongoing illness, disability, alergy or dietary requirements)

FLIGHT INFORMATION (if available)

Arrival:
Arrival Date:
Arrival Time:
Flight Number (arrival):
Originating Airport:
Airline (arrival):
Pick up-Service: *

Departure:
Departure Date:
Departure Time:
Flight Number (depart):
Departing Airport:
Airline (depart):
Drop off-Service: *

COURSE DETAILS

Universidad Internacional:
Program: *
Course Start Date: *
For how many weeks? *
Applying for Academic Credit?: *
Your Mother Tongue: *
Spanish Knowledge: *
Special Interests:	History
	Politics
	Social Structure
	Education
	Literature
	Mexican Music
	Mexican Traditions
	Arts and Crafts
	Religion
Please let us know your personal learning goal: *

ACCOMMODATION

Accommodation: *
Check in: *
Check out: *
Do you smoke? *
Any Special interest concerning your home stay?:	allergies? food restriction? pets?

MISCELLANEOUS

Will you travel after your project? *
Please confirm your email: *
How did you hear about us: *
Comments:	What did we forget to ask?

, I agree with the Terms and Conditions.

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Universidad Internacional (Uninter)