GLOBAL COMMUNITY LEADERSHIP APPLICATION- Kenya 2019
THIS FORM IS NOT THE FULL APPLICATION

In addition to this form, please also send in a 1 page personal statement about why you think you would be successful in this program AND one letter of recommendation from a teacher/professor/service supervisor about what makes you a good candidate.

All GCL participants also must read and sign the Policies & Code of Conduct form. This can be found here: http://www.youthlinc.org/pdfs/signature-page/

For questions regarding the application email office@youthlinc.org or call 801-467-4417.

This application is for the Youthlinc-USU Global Community Leadership program to Kenya in May 2019
APPLICANT INFORMATION
Legal Last Name as it appears (or will appear) on passport: *
If you do not have a passport at this time, you can still apply and get your passport later. Your name must be entered as it appears on your passport. This name will be used to purchase your flight.
Your answer
Legal First Name as it appears (or will appear) on passport: *
If you do not have a passport at this time, you can still apply and get your passport later. Your name must be entered as it appears on your passport. This name will be used to purchase your flight.
Your answer
Legal Middle Name as it appears (or will appear) on passport:
If you do not have a passport at this time, you can still apply and get your passport later. Your name must be entered as it appears on your passport. This name will be used to purchase your flight.
Your answer
Birth date: *
MM
/
DD
/
YYYY
Current age: *
Your answer
Age at time of trip departure (must be 18+ to join this program): *
Your answer
Passport number: *
If you don't have one put NA
Your answer
Passport expiration date: *
If you don't have one put 01/01/2000
MM
/
DD
/
YYYY
Country of citizenship: *
Your answer
Gender: *
As it appears in passport
Street Address: *
Your answer
City: *
Your answer
Zip: *
Your answer
State: *
Your answer
Cell phone number: *
Your answer
Home phone number *
Your answer
Applicant's email address *
Your answer
Indicate what year you are in school *
Cumulative GPA *
Type NA if graduated or not enrolled
Your answer
Name of college/university in which you are currently enrolled: *
Type NA if graduated not enrolled
Your answer
Are you interested in receiving college credit for this program? *
Are you interested in an extended international internship or travel after the Global Community Leadership trip? *
List past/current employment including start and end dates: *
Your answer
List involvement in community service clubs/activities including start and end dates:
Your answer
Enter second language(s) and your level of proficiency if applicable:
Your answer
T-shirt size (men's sizes):
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