4th Global Educational Tour Application Form
Step 1: Personal and Professional Information
Surname *
Your answer
Given Names *
Your answer
Full Name in Native Alphabet *
Your answer
Gender: *
Marital Status *
Your answer
Date of birth *
Your answer
Place of birth *
Your answer
Country of birth *
Your answer
Nationality *
Your answer
Do you hold other Nationality? *
Required
Home Address *
Your answer
Work Phone No. *
Your answer
Mobile Number *
Your answer
Email Address *
Your answer
Step 2: Passport Information *
Your answer
Passport No. *
Your answer
Date of Issue *
MM
/
DD
/
YYYY
Date of Expiry *
MM
/
DD
/
YYYY
Place of Issue *
Your answer
Has your Passport ever been lost or stolen? *
Your answer
Who will pay for your trip? *
Your answer
Organization/Company/School Name: *
Your answer
Title/Position: *
Your answer
Work Phone Number: *
Your answer
Work Address: *
Your answer
Were you denied US Visa before? Yes or No? If yes, Why? *
Your answer
Step 2: Essay
Please respond to the following question.
1. If admitted to one of the programs what would be your plan of action to serve your students upon return to your classroom? *
Your answer
1. If admitted to one of the programs what would be your plan of action to serve your students upon return to your classroom? *
Your answer
Step Three: Requirements
Submit two (2) letters of references:
a. From your supervisor
b. Colleague attesting to your performance and good moral standing
Terms and Conditions:
1. The Teacher's Gallery, Inc. reserves the right to request the U.S. Embassy to revoke my visa should I decide not to join the Global Learning Initiative.

2. Participants are expected to:
(a) Return to the Philippines, stay for a year after the EdTour to implement the action plan you have submitted in your application form;
(b) Articulate their observations and the knowledge learned on inclusive education by conducting a 1-day echo
seminar with their peers;

If accepted to participate in the Study Tour, I hereby agree to the terms and conditions set by The Teacher's Gallery, Inc. Specifically, TTG Reserves the right to request the US Embassy to revoke my visa should I decide not to join the Study Tour. *
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