Siglo XXI Spanish Language Insititute

27 E. Victoria Street, Suite E, Santa Barbara, CA 93101 Call or Text (805) 252-9512

Registration Form

 

PRINT-OUT PAYMENT/REGISTRATION FORM

Please print, fill in the required information and mail this payment form along with a check to
27 E. Victoria Street, Suite E, Santa Barbara, CA 93101
Please make check payable to A. Benavides – Siglo XXI

Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Street Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

City and Zip _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Telephone _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Email Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Please indicate the semester you would like to sign up for.      Winter     Spring      Summer      Fall

After you review our cost of program page and schedule page, please fill in the following information.Write the name of the class (Beginning I, Conversation, etc.) ___________________, the day(s)of the week_________________, and time of day _________________ it is held.
A $25 deposit is required upon registering. Tuition is payable in full at the first class.
(Tuition is not refundable after the first week of class.)

Countdown To Spring Semester

Spring 2018 Semester StartsApril 9th, 2018

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