Parent/Guardian Form: Ghana Exchange Program
You are being asked to fill out this form because your child has expressed interest in participating in the Ghana Exchange Program April, 2020.

Please be as detailed as possible in your responses so that we can best evaluate your child's eligibility for the trip. Your responses may also be of great help in matching those students who are selected.

Please consult for more information about the trip. If your question is not answered there, please feel free to e-mail or for additional information.
Email address *
Parent/Guardian Name(s) *
Parent/Guardian Address(es) *
Parent/Guardian Secondary Address (if applicable)
Parent/Guardian CELL Phone Number(s) *
Parent/Guardian WORK Phone Number(s) (write n/a if you don't have one!) *
Parent/Guardian HOME Phone Number(s) (write n/a if you don't have one!) *
Parent/Guardian additional e-mail address(es) *
Does your child follow a particular dietary regime of which we should be aware? If so, please describe. *
Does your child have any medical or emotional needs which we should be aware of? If so, please describe:
Please provide any additional information you feel is relevant about your family or about the applicant.
Would your family be able to host a student from Ghana for up to 10 days some time in the future? (Not necessary for your child to be accepted into the program)
Statement of Support
By submitting this form, I acknowledge that I have read the information contained in this application and description of the Ghana Exchange Program. I support the Program’s philosophy, understand the Program’s requirements and, to the best of my knowledge, have provided accurate and complete information.

I support my child's candidacy for the Ghana Exchange Program. *
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