Jordan Language Academy - Amman, Jordan

Admission

Gender * malefemale

First Name *:

Last Name *:

Email *:

Retype Email *:

date of birth *:

City *:

State / Province *:

Country *:

Zip / Postal Code *:

Phone *:

Fax *:

Date of Classes *:

Approximate length of Studies ? (number of weeks) *:

Anticipated departure Date from Amman *:

Citizenship *:

Occupation *:

Employer *:

What living arrangements would you like ?

Do you smoke? YesNo

Will you want airport pick-up service (8am-12 midnight)? There is an extra charge of $60 one way for this service. If you will be requiring pick-up between 10pm and 8am there is an additional $10 charge. If you are coming with other students, please contact us.

Flight arrival information (airline, flight number, arrival terminal, time of arrival). This helps for airport pick-up as well as informing homestay of approximate arrival time at their home.

Why do you want to learn Arabic? How will you use it after your studies?

Have you ever studied Arabic before (Please specify)?

Any other suggestions for topics or themes?

How did you hear about JLA ? *

Emergency Contacts: (Name, Relationship to you, Address, Phone, Email)

Any other information that you think would be helpful to us in arranging your stay (medical situation, allergies to animals, dietary needs, i.e. vegetarian, diabetes, etc)?

Would you like to be included on our mailing list for program updates and special promotions regarding JLA? YesNo