2017 Creativity for Peace Camp Application
All answers must be written in English.
Please mail a clear copy of the identity pages of your current passport, a copy of your visa (if you have one) and a copy of your identity card to: noa@creativityforpeace
First name:
Your answer
Surname:
Your answer
Birth date:
MM
/
DD
/
YYYY
I live in:
Your answer
ID number
Your answer
Name of high school:
Your answer
Now studying in class (grade):
Required
Father’s name:
Your answer
Mother’s name:
Your answer
Father’s profession:
Your answer
Mother’s profession:
Your answer
Home address (include post office box number, not simply the name of the village)
Your answer
Home phone:
Your answer
Parents’ email addresses:
Your answer
Parents’ phone numbers (home/cell/work)
Your answer
Personal cell phone:
Your answer
Personal email address:
Your answer
Religion:
Special dietary needs:
Required
Special physical needs:
Your answer
Passport country:
Your answer
Passport number:
Your answer
Passport Expiration Date:
MM
/
DD
/
YYYY
Name (in English) exactly as it appears on passport:
Your answer
Do you have a valid US visa (If yes, please write expired date):
Your answer
How did you learn about Creativity for Peace (i.e. a former camper, at school, the Internet, etc.)?
Your answer
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