UNIV – Application | Youth Service International

"*" indicates required fields

Personal information

Name*

First Last

Father's Name

Required if you are under 18 at the time of the trip

Mother's Name

Required if you are under 18 at the time of the trip

Email Address*

Email Address - Parent

Required if you are under 18 at the time of the trip

Address*

Street Address City State / Province / Region ZIP / Postal Code

Cell Phone Number*

Phone Number of Parent (emergency use only)*

Date of Birth*

City, State, Country of Birth*

This is needed because, when we register our conference with hotels in Rome, Italian law requires that the hotels collect some basic information about conference participants. Specifically, they need each person's name, date of birth, place of birth, and nationality.

Passport Information

Passport Name*

If you already have a passport, enter your name as printed in the passport. If you do not have a passport yet, enter your full name exactly as you will submit it in the passport application.

Visit travel.state.gov for instructions on getting a passport.

Passport Number

Passport Issuing Country*

Passport Expiration Date

Make sure that your passport will have six months of validity beyond the date of your return trip. Italy will not permit a traveler to enter the country unless their passport is set to expire at least six months after the final day of travel.

Education

School*

Current Year in School*

Major (if known)

Participation in the UNIV Conference

Participation*

Let us know if you are applying simply to attend the UNIV Conference or if you plan to formally participate in the conference. Be sure make your submission by the deadline.

I will just attend the conference

I will participate in the conference

Participation Type*

How do you plan to participate in the conference?

I will submit and present a research paper

I will submit a video

I will submit a work of art

I will compete in the Social Initiatives video competition

I will compete in the team debates

I will compete in the business case competition

Miscellaneous

Electronic Signature for Photo Release

Parents 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 images shall constitute property of YSI, solely and completely.

Diet, Medical

Do you have any special dietary needs or medical conditions that we should be aware of?

Reference*

Who recommended this program to you?

Comments