CISV 2021 Program Interest Survey

CISV 2024 Program Interest Survey

Please take a few minutes to fill out this survey about your interest in CISV programs for 2024.
What is your name?

First NameLast Name
For 2024, what CISV programs are you interested in for Child #1?

Other
For 2024, what CISV programs are you interested in for Child #2?

Other
For 2024, what CISV programs are you interested in for Child #3?

Other
Please check any country where you would NOT send your child?

If you have a child interested in Step Up, rank the geographic areas available.

Rows	Not Interested	Somewhat Interested	Most Interested
Europe
USA
North America (not USA)
South/Central America
Asia
Australia/New Zealand (winter)
MidEast

Info about Child #1, #2 and #3
Name of Child #1

First NameLast Name
Date of Birth of Child #1

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender of Child #1 (omit if you prefer not to answer)
Name of Child #2

First NameLast Name
Date of Birth of Child #2

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender of Child #2 (omit if you prefer not to answer)
Name of Child #3

First NameLast Name
Date of Birth of Child #3

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender of Child #3 (omit if you prefer not to answer)
What is your phone number?

Area CodePhone Number
What is your email address?
example@example.com
Should be Empty:

CISV 2024 Program Interest Survey