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| Your current level |
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| Level you would like to achieve |
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Native Language
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What is your personal goal for the course?
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Which other languages do you speak?
(at what level)
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Where do you live/work?*
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Where would you like to have your classes (office or home)
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When do you need to reach your target level by? (month/year)
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How many hours do you have available for study per week? (include time for self-study)
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What is your preferred start date?*
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Qualifications (language-related)
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What is your current
Spanish Proficiency Level?
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| 1 = none, 5 = very good |
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Which language skills do you need to improve?
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1 = not very important, 5 = very important
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In which of the following situations do you need to use the language?
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1 = seldom, 5 = very often
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Which nationalities do you currently have contact with?
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What is your occupation?
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Any other Relevant Information
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First Name*
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Last Name*
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e-mail*
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Daytime Phone*
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Organization
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Area of Business
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