Perú Service Project – Application Full Passport NameIf you already have a passport, enter your name exactly as it is printed on the passport. If you do not yet have a passport, enter your full name exactly as you will submit in the application to request your passport. If you do not have a middle name or initial, leave it blank.First Name*Middle Name or InitialLast Name*Personal InformationFather's Name*Mother's Name*Street Address*City*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZIP*Home Phone Number*e.g. 123-456-7890Cell Phone Number - Student*e.g. 123-456-7890Cell Phone Number - Parent*e.g. 123-456-7890Phone Number of Parent (emergency use only)*e.g. 123-456-7890Email Address - Student* Email Address - Parent* Please note: Both the student and parent email addresses will receive confirmation of your completed application after you click 'Submit' below. Both will also be used for all communication regarding the Peru Service Project: Announcements regarding acceptance or rejection to the program, deadlines, required travel forms, flight information, etc.Date of Birth* MM DD YYYY EducationName of School*Year in School (Fall 2019)*Grade Point Average*(eg. 3.8/4.0 or 92%)MiscellaneousDescribe any personal, academic, athletic, travel-related or professional achievements that may be helpful to you as a volunteer.*Foreign Language Skills*Do you suffer from any allergies and/or health conditions?*Click for YESClick For NOPlease specifyHobbies / Interests*Work Experience*Teaching Experience*Electronic Signature for Photo ReleaseParents must sign for applicants under 18 years of age. I hereby authorize and consent to the use and reproduction by YSI staff or an authorized agent or assignee of any and all photographs taken of the above-named applicant for the purpose of promoting YSI programs, without any compensation to me. All film, together with any prints, shall constitute property of YSI, solely and completely.Reference*Who recommended this program to you?CommentsEssay*Please write a short essay explaining why you want to participate in the Summer Service Project. What aspect(s) of the program do you find most appealing? How do you expect to contribute to the success of the program? You may want to draft your essay prior to completing the online application and then copy and paste it into the box provided.
