The Tertulia Project – Participant Application

The Tertulia Project – Participant Application

Travel with purpose. Connect with intention.This application helps us ensure alignment with our mission of reciprocal, community-based engagement in Colombia.
Full Name*

First NameLast Name
Preferred Name and Pronouns

Name Pronouns
Date of Birth *

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
City and Country of Residence*
Yes, UndergraduateYes, GraduateYes, DoctorateNo
Institution and Major if applicable
If you are not affiliated with a school, are you affiliated with an organization, or church or traveling independently?
YesNo
Yes, fluentlyYes, conversationallyNo
Service-learning / volunteeringCultural immersion in ColombiaLeadership & personal growthPre-med / healthcare exposureTravel experienceOther
English Language LearningHealthcareFood AccessAnimal WelfareDisability Inclusion
YesNoUnsure
YesNo
What month are you intending to travel? *
What year are you intending to travel?*
If you're group is affiliated with a school or university, select the week of intended travel:
Ready to commitWould need a payment planWould need financial supportPlanning to fundraiseJust exploringOther
How did you hear about us?
Schedule a quick info sessionReceive more details by emailBoth
Should be Empty: