Travel Abroad Application

ACE International Travel Abroad Application
Student Information
Name*

First NameLast Name
Birth Date*

MonthDayYear
Nationality
Personality Type
Home Phone

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Photo 1 w/your family*

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Photo 2 (optional)

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Photo 3 (optional)

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Parent Information
Mother's Name

First NameLast Name
Mother's Occupation
Mother's Cell Phone

Area CodePhone Number
Mother's E-mail
Father's Name

First NameLast Name
Father's Occupation
Mother's Cell Phone

Area CodePhone Number
Mother's E-mail

Do you have a religious affiliation? If so, which one?
Do you agree to accompany your host family to religious services if invited?
Do you speak French? If so, how many years have you been studying?
Do you smoke?
Do you agree not to smoke during your stay?
Do you have any chronic conditions such as allergies, diabetes, or epilepsy?
Have you ever had any psychological, nervous, or eating disorders?
Have you ever had major surgery or a serious illness or injury?
Will you need to take any medicines or have any treatments during your stay?
Do you have a special diet for medical or religious reasons?
Please explain in detail any questions that you answered yes

Please write a detailed letter to your host family introducing yourself. Tell them about what you enjoy doing, what you are looking forward to doing, and about your family. (250 word minimum)

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Once you submit your application, we will contact you shortly.

Thank you!
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