| PERSONAL
DETAILS |
| Name: |
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| Age: |
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| Current
address: |
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| Address
valid until: |
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| Email: |
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| Email
valid until: |
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| Telephone: |
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| Parent's
name: |
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| Parent's
email: |
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| Parent's
address: |
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| Parent's
telephone: |
(please include a number
that we can use in case of an emergency) |
| Give
us the name of your siblings and their ages: |
|
|
Give
us a name of a reference for you at your
school
such as your guidance counselor. |
| School
name: |
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| School
contact: |
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| Relation
to student: |
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| Telephone: |
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| Contact
email: |
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| School
address: |
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| I
am applyng for |
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1.
In order to give us some idea of who you
are, please tell us briefly about yourself,
your education, your interest, your family.
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2.
Why do you want to participate in Sojourn
Nepal Program?
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3.
Have you ever traveled abroad? If so, where
and what were your experiences?
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4.
Do you have any experience in the outdoors?
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5.
What would you most like to gain from this
experience?
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6.
Big or small, describe to us one of your
greatest accomplishments.
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7.
Big or small, describe to us one of your
greatest failures.
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8.
Your greatest concern about participation
in Sojourn Nepal.
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9.
What aspect of the program MOST/LEAST interests
you?
On a scale of 5=Most to 1=Least
| 1. |
Cross-cultural
experience (Homestay) |
|
| 2. |
Language
learning |
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| 3. |
Outdoor
experience(trek) |
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| 4. |
Group
acitivities |
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| 5. |
Individual
exploration |
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| 6. |
Apprenticeships |
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10.
Would you prefer to go on a fourweek trek
and extend your apprenticeship or spent
the entire pursuing an apprenticeship? (this
is for Nepal Semester only)
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11.
Do you have any preferences in regards to
what type of family you would like to live
with? You will be with your family for a
month so take into consideratin you needs
for privacy and modern comforts?
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12.
Please list any health problems or conditions
that you presently have, such as handicaps,
problems with hearing or vision, heart conditions,
high or low blood pressure, asthma, allergies,
muscle cramps, reactions to temperature
extremes, conditions relating to past injuries.
(NONE OF THESE WILL PROHIBIT YOUR ACCEPTANCE.
FOR YOUR SAFETY WE MUST BE AWARE OF SUCH
CONDITIONS.)
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13.
Have you ever had substance abuse problem?
sojourn Nepal counselors are not trained
in substance abuse counselling. If substance
abuse is an issue for you, we'd like to
knwo about it. Drugs are illegal in Nepal.
Sojourn Nepal recommends students with drug
abuse histories to look closer to home for
programs specifically designed to help you. |
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14.
How did you hear about Sojourn Nepal?
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15.
If you found out about the Sojourn from
our website, did you first link to it via
another site and if so, which one?
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| Some
students finid fieldtrips, lectures, family
life and trek sufficient activity. Would
you be interested in pursuing an apprenticeship
while in Nepal? If so, please check some
of the possibilities listed on the next
page that interest you. Please be aware
that these options apply to certain programs
only. (Please understand we ask you these
questions to help you begin thinking about
the kind of experience you would like to
have in Nepal .Your answers to the following
questions indicate your initial preferences.
You are free to change you mind after you
learn more.) |
