COURSE REGISTRATION FORM
OFFICE OF INTERNATIONAL PROGRAMS AND SERVICES
SPANISH COURSES
Medical Spanish
COST: 25 for the book TOTAL
6 Classes = $95.00 $ 120.00
5 Classes = $80.00 $ 105.00
4 Classes = $64.00 $ 90.00
Make check payable to: BiLingo LLC
DATES: February 16 - March 30 (Spring break March 9)
TIME:
CLASSROOM:
NAME:_______________________________________________________
ADDRESS:____________________________________________________
____________________________________________________
EMAIL ADDRESS:______________________________
TELEPHONE NUMBER:_________________ PAGER NUMBER:__________________
COLLEGE: (Students circle appropriate college)
Medicine Dental Medicine Pharmacy Health Professions Nursing Graduate Studies
OR
DEPARTMENT:_____________________________________
NO REFUNDS
