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What language(s) are you interested in studying?  



Name*:      

Address 1*: 

Address 2: 

City:      

State:       Zip/Postal Code: 

Country:   

Address type: Company   Home


Contact Information (please fill out at least one)*:

Telephone:     Fax:  

E-mail:    


Please tell us how you first heard about us*:


Internet   


Subway Poster      

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Yellow Book   


Verizon SuperPages   


Friend   


Referral
       Source/Name: 

 E-Mail 


 Window Display 


Other
      Source: 







Which program are you interested in?

Group classes               Corporate on-site classes

Semiprivate lessons (2 students)  Private lessons

Immersion program


What level?

Beginner      Beginner/Intermediate

Intermediate  Intermediate/Advanced

Advanced      Conversational






The following questions will help us to place you in a

class with students who share your interests and goals:


What is your occupation?  


What is your age?  


Why do you want to study a foreign language?

To meet school or degree requirement

Professional or career growth

Interested in language/culture

For personal/family reasons

Job requirement


Have you studied at The Boston Language Institute before? Yes   No



Please select one or two features of a foreign language program

that are most important to you:

Small classes         Experienced teachers

Committed students    Reputation of program

Price                 Money-back guarantee

				



Please enter any special questions or comments:







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