THIS FORM IS OUT OF DATE. If you've arrived at this page please start your registration at this link.

Registration Form

Please only complete this form if you've been instructed to do so by your program administrator at your home campus or ACLAS. If you have any questions about the form contact us.

1st step: Submit a photo

Before filling out this form, please submit a photo of yourself.

Find or take a photo of your face with no other people in the photo
Do not choose a photo where you are wearing a hat or sunglasses - we want to see your face
Re-name the photo file with your first and last name. For example, instead of 'IMG123.jpg' it should say 'Firstname Last Name.jpg'

To submit the photo, click on this link. Another page will open in your internet browser asking you to upload a photo to a folder called "Photo for Registration Form."

2nd step: complete this form:

Please note: It is not possible to save and return to this form. We suggest you review the form first, collect all the information you need and complete the form in one sitting.

First Name

Middle Name

Last Name

Photo submission confirmation

I promise I already uploaded a photo of myself following the instructions outlined under "1st Step: Submit a Photo" on this form.

Email Address

Please use an email address that you check regularly.

Gender

Male

Female

Your Day of Birth

The number. For example, if your birthday is January 2nd write '2'

Your Month of Birth

Write out month, do not put number. Example: January instead of 1

Your Year of Birth

Write the full year. For example, 1995.

Passport Number

If you do not have a passport, or your passport has expired enter '000000000' in the space below.

Nationality

Permanent Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Skype Name

If you have one

Phone Number

(###)

###

####

Emergency Contact 1 Full Name

Relationship to Participant

Emergency Contact 1 Phone Number

Emergency Contact 1 Email Address

Emergency Contact 2 Full Name

Relationship to Participant

Emergency Contact 2 Phone Number

Emergency Contact 2 Email Address

Name of Your Academic Institution (University)

Your Major(s)

How many hours of academic Spanish instruction do you estimate you've taken?

For example, a 3 credit course for most university systems means 45 hours of instruction. This can vary from school to school. Estimate the hours and write out any explanation in the space provided.

What languages do you speak?

What Spanish-speaking countries have you visited and for what length of time?

Homestay Family Placement Questions

The following questions help us place you with a homestay family. Please be very realistic and honest with your answers to this question. For example, when we ask if you like pets and you only like your pet and not all pets please say "no."

Do you smoke?

Do you mind smokers?

Do you mind pets?

Do you enjoy young children?

Do you enjoy older children?

Please describe your hobbies and interests

If you have any medical, religious or other limitations to what you may eat please elaborate here:

Please write a letter to your potential homestay family describing yourself and stating your expectations for your stay in Quito. You may write this letter in English unless you have an advanced level of Spanish. We will translate the letter for you before giving it to your family.

Comments?

If you need to elaborate on anything you've selected above please do so here. For questions, please contact us at aclas@aclas.org or using any other contact information you've been given.

THIS FORM IS OUT OF DATE. If you've arrived at this page please start your registration at this link.

Registration Form

1st step: Submit a photo

2nd step: complete this form:

Ecuador awaits.

For Students

For Faculty and Administrators