ISV - 2008 Canadian Application

INTERNATIONAL STUDENT VOLUNTEERS, INC
CANADIAN PARTICIPANT APPLICATION
NOV - FEB PROGRAM 2007/2008 & MAY - SEPT PROGRAM 2008

Full legal name that will appear on passport

Last Name	First Name	Middle Name	Nickname

Number & Street (Current address - While at school)	City	State	Zip	Country

Number & Street (Permanent address- While at school)	City	State	Zip	Country

Cell Phone	Email	Age
			Male Female

Home Phone	Alternate Email Address	Date of Birth

Country of Birth	Country of Residence	Citizenship

Emergency Contact 1	Relationship	Phone	Email Address

Emergency Contact 2	Relationship	Phone	Email Address

University (if applicable)	University Major (if applicable)	School year
		Freshman Sophomore Junior Senior Graduate Student Not a student

Do you have any physical disabilities? Please Explain	Yes No
Do you have any allergies? Please List	Yes No
Do you take any prescribed medications? Please list name and what it is for	Yes No
Do you have any special dietary needs? Please List	Yes No
Are you a returning ISV participant? If yes, what country & year?	Yes No
Do you speak Spanish? Yes No	If yes, how proficiently? Beginner Intermediate Advanced Fluent
T-Shirt size	S M L XL XXL

PROJECT PREFERENCE: Check the boxes that apply below. Remember, the more flexible you are, the easier it will be for ISV to reserve a place for you. (Your actual project will be assigned one month prior to departure to your host country).

	I am willing to do anything and have no project preference.
	I would like to participate in a conservation project. Australia, New Zealand, Costa Rica, Ecuador and Thailand
	I would like to participate in a social community development project. Costa Rica, Dominican Republic, Ecuador and Thailand.

Please state full name of any student/friend you would like to be placed with, as well as the name of the university they attend.

HOST COUNTRY: In the spaces provided number each country in order of preference ("1" is your first country preference). Then, check all the departure dates on which you are available to travel for each Program. Remember, the more flexible you are the easier it will be for ISV to reserve a place for you.


AUSTRALIA		NEW ZEALAND		THAILAND		COSTA RICA		DOMINICAN REP		ECUADOR
15 May 22 May 29 May 05 June 12 June 19 June 26 June 03 July	10 July 17 July 24 July 31 July 07 Aug 14 Aug 21 Aug	15 May 22 May 29 May 05 June 12 June 19 June 26 June 03 July	10 July 17 July 24 July 31 July 07 Aug 14 Aug 21 Aug	15 May 22 May 29 May 05 June 12 June 19 June 26 June 03 July	10 July 17 July 24 July 31 July 07 Aug 14 Aug 21 Aug	16 May 23 May 30 May 06 June 13 June 20 June 27 June 04 July	11 July 18 July 25 July 01 Aug 08 Aug 15 Aug 22 Aug	16 May 23 May 30 May 06 June 13 June 20 June 27 June 04 July	11 July 18 July 25 July 01 Aug 08 Aug 15 Aug 22 Aug	16May 23 May 30 May 06 June 13 June 20 June 27 June 04 July	11 July 18 July 25 July 01 Aug 08 Aug 15 Aug 22 Aug
		Winter Dates 2007/2008		Winter Dates 2007/2008		Winter Dates 2007/2008
			13 Jan	21 Nov 05 Dec	02 Jan 16 Jan	21 Nov 05 Dec	02 Jan 16 Jan			CROATIA
										16May 31 May 13 June 28 June	11 July 26 July 08 Aug

Why would you be a suitable participant on ISV's programs?

Date university classes end for summer (if applicable)	Date university classes begin in fall (if applicable)

Hobbies/interests: (Please list activities/interests you enjoy most)

Travel experience: (Please list all foreign countries to which you have traveled)

I am interested in:

	5-day Spanish Language and Latin Dance Lessons prior to the start of the ISV Program in Costa Rica/Dominican Republic/Ecuador.
	Optional Fiji 5-day Excursion at the conclusion of the ISV Program in Australia/New Zealand.
	One-week Galapagos Island Excursion at the conclusion of the ISV Program in Ecuador.
	How to receive donations from sponsors in my community that will go towards offsetting the cost of my Program.
	Earning Academic Credit. Note: Students are responsible for determining in advance the transferability of units to their home school. There will be anadditional cost for Academic Credit paid to the accrediting University, not ISV.

How did you find out about the ISV summer program?
ISV past participant:		Friend:		E-mail	Website	Myspace STA Travel
	Name		Name
Classroom/Flyer announcement Name of announcer						Other

LIABILITY AGREEMENT: I VERIFY THAT ALL THE ABOVE INFORMATION IS CORRECT; I FURTHER AGREE TO ABIDE BY ALL THE LAWS OF THE COUNTRY I WILL BE VISITINGINCLUDING, BUT NOT LIMITED TO, REFRAINING FROM ANY USE OF ILLEGAL DRUGS. I REALIZE THAT ISV REQUIRES EACH PARTICIPANT TO HAVE HIS/HER OWN TRAVEL/MEDICAL INSURANCE WHICH WILL COVER THE PARTICIPANT WHILE IN THE COUNTRY OF TRAVEL AND AGREE TO SECURE SUCH INSURANCE PRIOR TO MY DEPARTURETO MY FOREIGN COUNTRY. I HAVE READ, UNDERSTAND, AND AGREE TO ABIDE BY ALL THE POLICIES STATED IN ISV'S TERMS & CONDITIONS (SEE COPY ON THE ISVWEBSITE UNDER "TERMS & CONDITIONS" AT WWW.ISVONLINE.COM)

Your Signature	Date	INTERNATIONAL STUDENT VOLUNTEERS, INC.
		ADDRESS: 18032-C Lemon Drive, Yorba Linda, CA 92886 PHONE: (714) 779-7392 FAX: (714)777-4647 EMAIL: isvcan@isvonline.com WEBSITE: www.isvonline.com