Online Registration
This form has four sections. It should take about 15-20 minutes to complete but you must finish it in one session. You will need your passport, basic medical history and the date of your last tetanus shot.
First Name *
Your answer
Last Name *
Your answer
Nickname
Your answer
E-mail Address *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number (indicate if # is home, cell, or work) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact E-mail Address *
Your answer
Passport Number
Your answer
Passport Expiration Date
MM
/
DD
/
YYYY
Passport Issuing Country
Your answer
Room Preference (only applies to health care and gardening program participants)
Name of Preferred Roommate (if applicable)
Your answer
Name of Local Newspaper
Your answer
.
T-shirt Size *
Which Tandana program will you be participating in? *
What are the dates of your Tandana program?
Your answer
Do you plan to travel on your own outside of the Tandana program?
How many Tandana programs have you participated in previously?
Do you have any food preferences? (we don’t have the ability to accommodate everything but we will try)
Your answer
Why do you want to participate in this program?
Your answer
Please describe any relevant skills you have. (e.g. translation skills, medical training, gardening experience, teaching experience, masonry, etc.)
Your answer
Please describe your Spanish language ability (Ecuador) or French language ability (Mali). Language skills are not necessary, but knowing your level helps us plan.
Your answer
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This form was created inside of The Tandana Foundation.