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Name

Primary E-mail Address

Alternate E-mail Address

Primary Phone Number

Alternate Phone Number

Complete Mailing Address

Date of Birth

Sex



Which Peru 109 program are you applying for?

(Winter Session, ASB, Summer Session I / II or Self-Direct and Connect)

Which program dates do you anticipate traveling?

(only if you are applying for ASB, or Self Direct and Connect )

Are you currently a student?

If yes, please tell us with which institution you are studying.

Are you currently employed?

If yes, please tell us the nature of your position.

What are your current oral, written, and comprehension levels of Spanish?

Have you ever visited or lived in a country other than the US?

(Please note length and purpose of stay.)

Describe any experiences you have had with community service.

What community and social issues interest you?

How will you contribute to the community projects in Peru?

What do you expect to gain from the experience?

As a part of the PERU 109 Team, you will need to work with people

from various backgrounds. Do you consider yourself to be 'flexible"?

Give an example of a situation in which you have demonstrated flexibility .

How did you hear about Peru 109 ?


NOTICE: We try to respond personally to every inquiry and application.

Please call us TOLL FREE (1-888-737-8109) if you have not received an e-mail response within 48 hours.

Thank you for your time!