Study + Visa: Application Form

Fields marked with an * are required

Program Information

Program Applying for*

If other, specify:

Three career interest areas for your internship (in order of choice):*

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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