Application for
INSIDE THAILAND

June 17 - July 17, 2011

_________________________________________________________

Please copy and paste this page into an E-mail message.
Use additional space as necessary to answer all questions,
then return via E-mail to: office@insidethailand.net

If you prefer, you may Fax or mail the PDF Application Form available here.
(Please note that the PDF form requires Acrobat Reader, available here.)

Application deadline is April 15.
Due to limited group size, early applications are strongly encouraged.
Interviews will be scheduled as applications are received.
Deposits of $1,000 are due no later than April 15.

(Checks payable to: Cate School-Inside Thailand)

_________________________________________________________

Applicant's name:

Gender:

Birthdate:

School:

School location (city & state):

Graduation year:
___________________

Parent(s) or guardian(s):

Applicant lives with (mother, father, or both parents):

Home address:

City:

State:

Zip Code:
___________________

Parent's home phone:

Parent's work phone:

Parent's cell phone:
___________________

Father's E-mail:

Mother's E-mail:

Applicant's E-mail:

_________________________________________________________

• Please list any travel or camping experience.
 

 

• Please list additional interests, skills or experience you would like us to know about.
 

 

• Please describe what you expect to bring to and gain from this adventure.
 

 

• Briefly describe a challenging and successful new experience which you really enjoyed.
 

 

• Briefly describe an unsuccessful personal experience and explain how you coped with your frustration.
 

 

• Briefly sketch your own personality as you would like to be remembered by the people you meet in Thailand.
 

 

• Do you have any medical condition, allergies, special diet or medications that we should know about? If yes, please explain.
 

 

_________________________________________________________

    Inside Thailand
    126 La Plata, Santa Barbara, CA 93109

    Phone: (805) 963-8073
    Fax: (775) 248-7362

    E-mail: office@insidethailand.net
    http://www.insidethailand.net

_________________________________________________________
 

Home | Brochure | Application | Slide show | Scrapbook | Village library | FAQ | Group login