Baltic Solidarity Project – Application | Youth Service International

Personal Information

Name*

First Last

Address

Street Address City State ZIP Code

Cell Phone Number*

Phone Number of Parent (emergency use only)*

Email Address*

Date of Birth*

University or College*

Major*

Expected Year of Graduation*

Please specify*

Any special diet requirements?*

Any special medical issues?*

Reference*

Who recommended this program to you?

Comments

Please briefly explain your interest in the program, and any similar past experiences*

50-75 words

What languages do you speak?*

What special interests, hobbies or skills do you have, including sports?*

50-75 words