app 2014 form for sea
TRANSCRIPT
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8/11/2019 App 2014 Form for SEA
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I. PERSONAL INFORMATIONComplete name as appears in NSO birth certificate/passport: (Last/First/ Middle) Birthdate:
(mm/dd/yyyy)Gender:
MaleFemale
Complete home/mailing address: (House No., Street, Barangay, City/ Municipality, Province) Region: Zip Code:
Home phone with area code: Mobile Phone/ s: Email:
Name of Father/Legal Guardian (for minors): Name of Mother/Legal Guardian (for minors):
J ob/ Occupation & Employer Name: J ob/ Occupation & Employer Name:
Work or Mobile Phone/ s: Email/s: Work or Mobile Phone/ s: Email/s:
Passport No. (If available): Passport issue date: Passport expiration date: City/ Country issuingpassport:
Religion: ChristianityIslamOther
__ __ __ __ __ __
I am allergic to: Foods I cannot eat: Native/Foreign languagesspoken:
AFS Programs: I learned about AFS through
AF S returnee/alumni/volunteer School Friends/Relatives Internet Print (Newspaper/Brochure/Poster) Other __ __ __ __ __ __ __ _
II.
SCHOOL/ EMPLOYER INFORMATIONComplete school/ company name:
Complete school/ company mailing address: (House No., Street, Barangay, City/ Municipality, Province): Region: ZipCode:
Complete name of school principal/administrator/immediate supervisor:
Telephone/s: Fax: Email/s: Mobile Phone/s:
For student only: Year Level inJ une 2014:
For student only: Average grade inprevious school year:
For Teacher only: PRC License No.: For Adult only: Martialstatus & No. of dependents:
III.
AFS PROGRAM SPECIFIC
Core P rogram Duration:
I choose to go abroad on:
Year Program (YP)
Semester (SM) P rogram
Tri-mester (TR) Program
Intensive Program (IP)
Very Short (VS) P rogram
I choose to start my travel on:
J anuary J une (SH cycle)
J uly - December
Program Content:
Class Exchange
Community College
Community Service
Culture Study & immersion
Educator
Foreign Language
High School
Internship
Teacher Assistant
Volunteer
Other: _________ ________ ___
Preferred AFS Partner:
I Choose to go to an AFSDestination/Host country in:
Asia
Europe
North America
South America
Africa
My top 3 destinations are:
1.
__ __ __ __ __ __ __ __ __ __ _
2. __ __ __ __ __ __ __ __ __ __ _
3. __ __ __ __ __ __ __ __ __ __ _
Please attach
passport-size w/
white background
photo
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8/11/2019 App 2014 Form for SEA
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_____________________
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Attention: SENDING PROGRAM
AFS Intercultural ProgramsPhilippinesUnit 1607 16/ F Antel Global Corporate CenterNo. 3 Doa J ulia Vargas Avenue, Ortigas Center1600 Pasig City, Metro Manila, Philippines
Tell us about yourself: Introduce yourself (I.E how you see yourself, your personality, your relationship with your family and friends, yourresponsibilities at home and at your school, list your favorites, interest and hobbies, organization memberships, volunteer initiatives, and indicatehow often you pursue them, etc. Please attach separate sheet, as needed.)
I hereby certify that all information provided in this application from are true and correct to the best of myequired, if applicant is a minor)
Date ofapplication:
Date receivedby AFSvol/staff:
SUBMIT APPLICATION:Via Post Mail: Unit 1607 16/ F Antel Global Corporate Center, No. 3 Doa J ulia Vargas Avenue, Ortigas Center, 1600 Pasig City,
Metro Manila, PhilippinesOnline: https:// www.afsglobal.org/AF SGlobal/OnlineApplicationTelefax:+63 (2) 584 2002 Email: [email protected]
Complete name as appears in NSO birth certificate/passport (Last/ First/ Middle) Program:
MailingStamp
mailto:[email protected]:[email protected]