Spanish for Educators: Immersion Program Application

Teachers Immersion Registration Form

We’re excited to have you on our upcoming Spanish Immersion program!

Please complete your trip registration. If you have any questions or trouble completing this registration form, please contact u s.

Spanish for Teachers Immersion Application

2024 Educators Immersion Registration

Please fill out this registration form in its entirety and submit. Your information may or may not be saved on this page if you navigate away.

Tell us how you heard about this program?*
Do you remember if you were searching online... some sort of advertisement... social Media... a presentation, a friend?
Select Your Immersion Program
Which Spanish for Educators Immersion Program are you applying for?*
Programs technically begin on Monday morning at 8am. However, we usually have activities scheduled for the Sunday prior, including an orientation and walk around town. We suggest you arrive in country on the Saturday before the program begins. If you're arriving while the program is already underway, consider arriving on the Friday before so that you can join us on a weekend excursion!
Yay, thanks for being a 3+ week customer! We'd like to give you an immersion T-Shirt 🙂
Please select your size. These are standard unisex T-Shirts... and they fit pretty true to size.
- XS
- S
- M
- L
- XL
- XXL
Do you anticipate needing flexible start/end dates? OR - Have you pre-arranged custom trip dates?*
We're happy to work with you on your start/end dates within reason; let us know what you need! If you've pre-arranged custom dates with CGI, please specify here...
Personal Information
Name*
First Last
Grade level / Subject Area*
Employer / School where you currently teach*
Home Phone*
Cell Phone*
Email*
Please provide an email address that you check regularly. Program updates and documents will come to you primarily via this email address.
Gender Identity*
Please add your preferred pronouns here as well
Date of Birth*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Will any children, family members or special friends accompany you?*
- Yes
- No

Please list each of the family members traveling with you:

First & Last Name	Gender	Date of Birth	Passport number & Expiration	Allergies (Food & other)	Medical Conditions

Emergency Contact Information
Full Name*
Relation to Participant*
Email*
Cell Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Passport Information
Name Exactly as on Passport
First Last
Passport Number
You absolutely need a passport to travel, however this section is not required to fill out your application in case you don't have one yet or it needs to be renewed. Please fill out this information if you have a valid passport.
Date of Issue
Please enter this date as it is on your passport: Month, Day, Year
MM
DD
YYYY
Date of Expiration
Please enter this date as it is on your passport: Month, Day, Year
MM
DD
YYYY
Is your passport issued by the United States of America?
- Yes
- No
What country has issued your passport?
Medical Information
Primary Care Provider*
Phone Number*
Medical Insurance Carrier*
Policy Number*
Health Conditions*
List any health conditions (physical, mental, etc.) that we should know of. Conditions exacerbated by stress and fatigue would be particularly important to include. This information is kept strictly confidential; please include everything that will help us keep you safe and healthy while traveling abroad.
Medications*
Please list any medications / vitamins you are taking. This information is kept extremely confidential, but is useful in case of emergency.
Have you completed the COVID - 19 Vaccination?*
Please select "yes" if 100% done, "No" if not at all, & "Other" and provide detail if you've not completed your vaccination regimen.
- Yes
- No
COVID - Underlying Conditions
Please list any underlying conditions you have that may complicate your health if you were to contract COVID 19 while abroad.
Allergies
Please list any and all allergies to food, insects, medications, etc
Special Dietary Needs
Please list all special food requirements you require.
Host Family Information
Would you like a special recommendation for Hotel or Hostel Lodging?*
Our standard program includes host family lodging and 2 meals/day.

However, some travelers are uncomfortable with that. Please let us know if you plan to opt-out of host family lodging. This will require special hotel or hostel recommendations that we're glad to provide, but you'll take care of paying directly to the hotel or hostel.
- Yes
- No
Do you prefer a family with or without children?*
- With Children
- Without Children
- Doesn't matter
Do you need any special accommodations at your host family? Dietary, physical, other?*
Do you smoke?*
Spanish Language Experience
Briefly Describe your Spanish experience*
Please include number of years of Spanish in high school, college, or any related foreign travel, etc.
Are you able to comfortably communicate in the present tense in Spanish?
- Sí
- No, ayúdame
Are you able to comfortably communicate in the past tense in Spanish?
- Sí
- No, ayúdame
Are you able to comfortably communicate using commands in Spanish?
- Sí
- No, ayúdame
Are you able to comfortably communicate using the subjunctive in Spanish?
- Sí
- No, ayúdame
Speaking Proficiency*
Oral Comprehension*
Reading Comprehension*
Writing Ability*
Please explain why you wish to participate in this program and what you hope to gain from it.*
Are you interested in receiving CEU credits OR graduate level credits for this Spanish immersion program?
.
- Yes
- No
Payment Information
Is your school or employer paying for this immersion program?*
- Yes
- No
Employer / School contact name that will be handling payment*
Employer / School Contact Email Address*
Employer / School Contact Phone*

Save and Continue Later

5 thoughts on “Teachers Immersion Registration Form”

Pauline Katz
May 7, 2022 at 8:31 am

Pretty psyched to meet all of you and live and learn in another culture for a while.

Reply
JILL WHITMIRE
March 13, 2022 at 5:57 pm

I am beyond excited! It is my first time traveling out of the U.S., and I’m excited to meet new friends and learn Spanish to help me communicate with the families of my students!

Reply
Bennae Dillingham
February 21, 2022 at 10:17 am

I can’t wait for the trip. I am SUPER excited to take on this new adventure!

Reply
Cara Lyn Bahney
January 28, 2022 at 3:20 pm

I’m so happy to be apart of this!

Reply
Nancy Schultz
May 5, 2021 at 12:13 pm

I am super excited!

Reply

Teachers Immersion Registration Form

We’re excited to have you on our upcoming Spanish Immersion program!

Please complete your trip registration. If you have any questions or trouble completing this registration form, please contact us.

Spanish for Teachers Immersion Application

2024 Educators Immersion Registration

Select Your Immersion Program

Personal Information

Emergency Contact Information

Passport Information

Medical Information

Host Family Information

Spanish Language Experience

Payment Information

5 thoughts on “Teachers Immersion Registration Form”

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Please complete your trip registration. If you have any questions or trouble completing this registration form, please contact u s.