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* 1. Title

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* 2. Given Name(s)

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* 3. Family Name(s)

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* 4. Contact Information:

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* 5. Please check the languages in which you can train. Please check all that apply.

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* 6. Have you delivered 1 and 2 day intercultural relocation programs?

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* 7. Have you trained youth programs?

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* 8. Have you trained teen programs?

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* 9. For which contract position(s) would you like to be considered? Check all that apply.

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* 11. In what countries have you lived and worked and for how long?

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* 12. Are you comfortable acting as the cultural business consultant in a relocation program (usually a 1.5 – 2.0 hour segment) for any countries? If so, please list them in descending order of your expertise.

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* 13. For what other relocation providers have you trained? (Answer is Optional)

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* 14. Who are your personal favorite heroes in the intercultural field and why?

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* 15. What part of your education and/or professional development is most relevant to your role as an intercultural professional?

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* 16. Please copy and paste a short bio into the box below. (2,000 characters max.)

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