Study + Visa: Application Form

Fields marked with an * are required

Program Information

Program Applying for*

If other, specify:

Three Internship Area Choices*

Start Date*

Finish Date*

Housing Options*

Resume translation

Do you have health insurance?

Which?

How did you learn about BEST´s Program?

EDU-TRAVEL CHOICES FOR CUBA

What classes/activities in Cuba are you applying for? (Only Cuba participants)

  • La Havana SalsaSpanishMusicNone
  • Santiago de Cuba SalsaSpanishThai MassageInternship/VolunteerMusicCaminata Heroes Hike

Desired start date (Only Cuba participants)

Length of stay (weeks) (Only Cuba participants)

I would like to request an individual room (Only Cuba participants)

I will share a room with (Only Cuba participants)

Personal Information

First Name*

Last Name*

Email Address*

Birthday*

Address 1*

Address 2

City*

State*

Zip / Post Code*

Country*

Landline Phone

Cell Phone*

Skype

Facebook

Website

Country of Birth*

Citizenship*

Passport Number

Passport Expiration

Will you need a study visa?

Emergency Contact Details

First Name*

Last Name*

Relationship to You*

Phone*

Email*

Address 1*

Address 2

City*

State*

Zip / Post Code*

Country*

Additional Questions

Do you speak other languages?*

If yes, what languages and what level?*

Do you smoke?*

Do you have any allergies or diet requirements?*

I agree to the Terms & Conditions and Cancellation Policy*

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