INTERNSHIP APPLICATION

Please contact the Internship Coordinator prior to application.

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Personal Information
Name
Last Name
Sex
Birth Date
Nationality
Apt# / Street 
City
State and Country
Postal Code 
Telephone (Home)
Telephone (Work)
Fax
E-mail
Telephone # and name of a responsible person for emergencies
Passport #


Internship Details
Internship you are applying for
Date you wish to start  
# of weeks
Are you applying for credits? Yes 
No
If yes, answer the questions below
How many credits do you wish to obtain ?
Name of University/College


Family
Special dietary needs No
Vegetarian
Others 
I would rather live with a family with children
without children


Health
Do you have any medical problem? No  Yes 
Do you have any allergies? No  Yes 


Travel
Would you like to be met at the airport? Yes  No
If yes, answer the questions below
Which Airport?
Airline
Flight#
Date of arrival
Time of arrival (Guatemalan Time)


Payment
You wish to pay by: Bank Transfer
(Please see our contact page for the account information.)
Check (indicate check number, amount, date and send to our USA office)
Total amount of check (US$)
Number of check
Date send by mail

If paying by bank transfer, please call our USA office (see Contact page) for account information.
If paying by check, send to USA office (see Contact Us page).

If we do not receive your check within 8 days of receiving your application, your name will be automatically deleted. After receiving your registration and deposit, we will call you for an interview. If you are accepted, we will e-mail you a confirmation. Please do not forget to send us all the neccesary items listed on the requirements page.


Inquiry
Where did you learn about Casa Xelajú?
How do you wish to receive your booking confirmation? E-mail
Regular Mail
Fax

Your Comments and sugestions will be appreciated.

Thank you for your interest in Casa Xelajú

I acknowledge that I have read and understand the conditions presented and understand my financial obligations which begin upon receipt of my confirmation.