SRS 4 Monthly Form – Bilingual America

Please complete the form below to officially register for your Spanish course. After you submit it, check your email to confirm your email request, and then you will receive your access information and instructions to begin the course.

SRS 4 Monthly

First Name

Last Name

Office Phone

Mobile Phone

Title or Position

SRS Employee ID Number

Address (we only mail certificates and requested documents)

Street Address

Suite or Apartment Number

City

State

Zip Code

Country

Reason to Learn Spanish

Commitment: Do you agree to commit to following instructions and dedicating the necessary time and energy to succeed in this course? (The time commitment on average is 4 to 6 hours weekly and also includes taking two 30-minute private tutoring sessions weekly on video.)

Course Resignation: In the event you feel the need to pause, or withdraw from the course, do you agree to first speak with Bilingual America administration and if we are unable to resolve, request formal permission to withdraw from the SRS Talent Development leader of this program?

Email Consent: By clicking this box, I agree to receive emails from Bilingual America to service my account. I understand that if I desire to unsubscribe in the future, I can do so at the bottom of any email.