Summer Abroad Student Volunteer Program
Exit this survey

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1. NAME

NAME Surname
Given Name
Male(M)/Female(F)

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2. SCHOOL INFORMATION

SCHOOL INFORMATION Current School
School Phone Number
Current Grade
School Principal

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3. DATE OF BIRTH

	MM		DD		YYYY
4-digit birth year	DATE OF BIRTH 4-digit birth year Month	/	Day	/	Year

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4. CITIZENSHIP

CITIZENSHIP

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5. NATIVE LANGUAGE

NATIVE LANGUAGE

6. OTHER LANGUAGE(S) SPOKEN

OTHER LANGUAGE(S) SPOKEN

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7. ADDRESS

ADDRESS Street # and Name
City
Province
Postal code

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8. CONTACT INFORMATION

CONTACT INFORMATION Home Phone Number
Cell Number
Parent Cell Number
E-mail Address
Parent E-mail Address

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9. REFERENCES: List the contact information of 2 references. They will be sent a form to complete and submit as part of the application process.

REFERENCES: List the contact information of 2 references. They will be sent a form to complete and submit as part of the application process. Reference 1 Name
School
Subject Taught
Phone Number
E-mail Address
Years Known Applicant
Reference 2 Name
School
Subject Taught
Phone Number
E-mail Address
Years Known Applicant

10. Have you participated in this program before?

Have you participated in this program before? Yes

Deadline for applicaitons is Monday, March 19, 2012. Please send completed applicaition form, resume and written essay (750 words or less) about "Why I would make a good ambassador to the Student Volunteer Program" either by mail or ask for it to be sent through the Board Courier to:

Elizabeth Burnett
c/o Community and International Education Services
Dr. Bette Stephenson Centre for Learning
36 Regatta Ave.
Richmond Hill, ON
L4E 4R1
(905)884-2046 Ext. 263
elizabeth.burnett@yrdsb.edu.on.ca

Summer Abroad Student Volunteer ProgramExit this survey

*1. NAME

*2. SCHOOL INFORMATION

*3. DATE OF BIRTH

*4. CITIZENSHIP

*5. NATIVE LANGUAGE