Spanish on the river Enrollment Form

Online Workshop Enrollment Form
Please fill in the information below. You can either print this form and fax it to us at
(541)-896-0155
or mail this form to us at:
Spanish on the River
PO Box 1133
Leaburg, OR 97489

FIELDS MARKED WITH * ARE REQUIRED

  

  Your Name:*       

  Address:*         

  City/State/Zip:*  

  Phone:*           

  Fax:              

  E-Mail Address:*  

  Emergency Contact Name & Phone Number:* 

   		 
 		
		May we add you to our Mailing List:  Yes         No

   Date of Previous Spanish on the River Workshop (if applicable): 

   


   Workshop Preferences


   INTRODUCTION TO SPANISH       INTRODUCTION TO PAST TENSE      SPANISH FOR TEENS
   SPANISH REVIEW I              MASTERING PAST TENSE 
   SPANISH REVIEW II             ADVANCED CONVERSATION                      
                                          

   Workshop Date You Wish to Attend:* 

 

   Occupation/Hobbies:* 



   What are you goals for learning Spanish:

    


   If you have studied spanish before, Please tell us when and how much:

    



   Please tell us your personal interests:

 	History           Literature               Mexican Traditions
 	Politics          Arts & Crafts            Hispanic Music 
 	Education         Religion                 Other
 
 

   How did you find us: