International Student Volunteers, Inc.

All Other Applicants

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	T-Shirt size
Freshman Sophmore Junior Senior Graduate Student Not a student	S M L XL XXL

Do you have any physical disabilities?	Yes No	Please Explain
Do you have any allergies?	Yes No	Please List
Do you take any prescribed medications?	Yes No	Please List
Do you have any special dietary needs?	Yes No	Please List
Are you a returning ISV participant? If yes, what country & year?	Yes No

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 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.
	I am willing to do anything and have no project preference.

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, circle all the departure dates on which you are available to travel in each 2-week program during May through September 2007. Remember, the more flexible you are the easier it will be for ISV to reserve a place for you.


AUSTRALIA		NEW ZEALAND		COSTA RICA		DOMINICAN REP		ECUADOR		THAILAND
17 May 24 May 31 May 7 June 14 June 21 June 28 June 5 July	12 July 19 July 26 July 2 Aug 9 Aug 16 Aug 23 Aug	17 May 24 May 31 May 7 June 14 June 21 June 28 June 5 July	12 July 19 July 26 July 2 Aug 9 Aug 16 Aug 23 Aug	18 May 25 May 1 June 8 June 15 June 22 June 29 June 6 July	13 July 20 July 27 July 3 Aug 10 Aug 17 Aug 24 Aug	18 May 25 May 1 June 8 June 15 June 22 June 29 June 6 July	13 July 20 July 27 July 3 Aug 10 Aug 17 Aug 24 Aug	18 May 1 June 15 June 29 June	13 July 27 July 10 Aug 24 Aug	18 May 1 June 15 June 29 June	13 July 27 July 10 Aug 24 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)

Do you speak Spanish? Yes No

If yes, how proficiently? Beginner Intermediate Advanced Fluent

	I am interested in the 5 day Spanish Language and Latin Dance Lessons (Costa Rica/Ecuador/Dominican Republic programs only. ) (see info on website) Note: There will be an additional cost for Spanish Lessons, and participants will depart early.
	I am interested in the Optional Fiji 5-day Excursion at the conclusion of the ISV program in Australia/New Zealand (see info on website).
	I am interested in the one-week Galapagos Island Excursion at the conclusion of the ISV program in Ecuador (see info on website).
	I am interested in earning Academic Credit (for details, go to our website www.isvonline.com). Note: Students are responsible for determining in advance the transferability of units to their home institutions. There will be an additional cost for Academic Credit.
	I am interested in finding out how to receive donations from sponsors in my community that will go towards offsetting the cost of my program

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

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 VISITING INCLUDING, 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 DEPARTURE TO 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 ISV WEBSITE 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: info@isvonline.com WEBSITE: www.isvonline.com