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Youth Exchange
Applicant Information
First Name
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Middle
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Last name
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Gender
Permanent Address
Street
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City
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Postal code
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State
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Country
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Temporary Address
Street
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City
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Postal code
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State
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Country
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Date of Birth
MM
/
DD
/
YYYY
Place of birth
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Blood Group
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Religion
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Email address
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Contact number
mobile
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home
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Citizenship number
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Passport number ( if have)
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Parent/Legal Guardian Information
Full name of Father
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Address
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contact number
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Occupation
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Full name of mother
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Address
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contact number
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Occupation
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Personal Background
Do you have any health problem or medical health history ?
If yes , please mention details
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Do you have any dietary restrictions ?
If yes , please explain (eg. vegetarian , food allergies )
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Do you smoke ?
Do you drink alcoholic beverages ?
Educational Backgrounds
Name of your College/University
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Address
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Course
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Languages
Native language
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Non - native languages
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Skills (Please check)
Technical Skill
knowledge-based skills
Personal traits
Clubs/Organizations
list the name of organizations you are involved with
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Period of involvement
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What is your motivation to participate in this exchange program ?
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Briefly explain : Your role as a youth in the development of the society
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