All NRCSA program fees are in US Dollars. NRCSA welcomes participants of all nationalities from any country around the world.
1. Please complete and send to NRCSA, P.O. Box 1393, Milwaukee, WI 53201, USA.
2. A non-refundable deposit of $100 USD (applied towards the cost of the program) and non-refundable registration fee of $40 USD per person, per program, payable to NRCSA (Total of $140 USD).
NOTE: The registration fee of $40 is waived for NRCSA alumni who have taken a NRCSA program since January 1, 2000.
3. Register early. Add a $40 USD per person late fee if paying in full within 40 days of departure. Within 20 days, all payments must be made by certified check.
4. Credit Cards may be used for deposits (see "G" below). NRCSA's Fax is (414) 271-8884. NRCSA street address for overnight deliveries is 207 E. Buffalo St., Suite 610, Milwaukee, WI 53202, USA. Please send separate form for each school if taking multiple programs.
5. If you have any questions about the registration process please contact NRCSA at (414) 278-0631.
Please print A.Name(s)__________________Sex____Birthdate________Citizenship____ Employer__________________________Occupation______________________ If student, school attending and year Street:________________________________Tel. Home:_________________ Street address (not P.O. Box) where someone can sign for documents sent to you. City/State/Zip:________________________Tel. Work:_________________ Email Address: ___________________________________________________ In Emergency, notify:_____________________________________________ (Name, Address, Phone) B. BACKGROUND:_________________________________________________ Describe any foreign language study and/or travel experience. Check appropriate level: Beginner_____Post Beginner______Intermediate______Advanced______ C. LODGING:_____________________________________________________ Indicate preferences which will be matched when possible. Single Room_______ Share Twin_______ Other Lodging________________ Yes Smoking_______ No Smoking_______ Either________ Yes Pets__________ No Pets__________ Either________ Yes Children______ No Children______ Either________ Special diet(At an additional cost and may not be available)_______ Hobbies Reading___ Music___ Cooking___ Sports___ Jogging___ Objectives Enrichment___ Academic Credit___ Job Related___ Are You Quiet___ Outgoing___ Frequent Traveler___ D. GOALS:_______________________________________________________ E. INSURANCE: Included for prepaid study dates. If you leave early/return later and want to extend coverage, add $19/addl wk (or fraction) and advise dates. F. PROGRAM ATTENDING City____________________________ School____________________________Start Date(program)_____________ Start Date(lodging)_______________2nd Choice Program______________ Program(name from dates/fees______________________________________ Number Weeks attending____________Number hours day/week___________ Allergies/Health problems_________________________________________ How did you learn of NRCSA________________________________________ Social Security number____________________________________________ Options(see program for choices)___________________________________ Your Signature____________________________________________________ If under 18, a parent must sign also. G. CREDIT CARDS May be used for program deposit not final payment. Indicate card VISA______ Mastercard______ Discover______ American Express______ Amount Charged $ _________________ Card Number (13 plus number): ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Expiration Date ___ ___ /___ ___ _ SIGNATURE (as on card) __________________________________________ PRINT name (as on card)__________________________________________
Conditions and Refunds please check here before registering.