INTERNATIONAL STUDENT VOLUNTEERS, INC
CANADIAN PARTICIPANT APPLICATION
*required fields
Full legal name that will appear on passport
First Name * Middle Name Last Name * Nickname
Current Street Address * City/Town * State/Province * Postal Code * Country *
Permanent Street Address City/Town State/Province Postal Code Country
Primary Phone Number * Primary E-mail Address * Age *

Gender
Male Female
Secondary Phone Number Alternate E-mail Address Date of Birth *
Country of Birth Country of Residence Citizenship *
Emergency Contact 1 * Relationship * Phone * E-mail Address
Emergency Contact 2 Relationship Phone Email Address
University * University Major School Year  


Do you have any medical conditions or physical disabilities?
Please Explain

Do you have any allergies?
Please List 		Yes No
Have you been hospitalized in the last 12 months?
When? And Why?
Do you take any prescribed medications?
Please list name and what it is for
Do you have any special dietary needs?
Please List
Are you a returning ISV participant?
If yes, what country & year?
Do you speak Spanish?
T-Shirt size
PROJECT PREFERENCE: Check the boxes that apply below. Remember, the more flexible you are, the easier it will be for ISV to reserve a place for you. (Your actual project will be assigned one month prior to departure to your host country).


Please state full name of any student or friend you would like to be placed with, as well as the name of the university they attend.
 
HOST COUNTRY: In the spaces provided number each country in order of preference ("1" is your first country preference). Then, check all the departure dates on which you are available to travel for each Program. Remember, the more flexible you are the easier it will be for ISV to reserve a place for you. Please note that ISV assumes all participants traveling to Costa Rica, the Dominican Republic or Ecuador will be taking the five-day Spanish lessons package in the same country prior to the beginning of their ISV Program (You may opt out of the five-day Spanish lessons package once you are confirmed to travel with ISV, particularly if you already speak Spanish fluently).

Australia Costa Rica Dominican Republic Eastern Europe
13 May
20 May
27 May
03 June
10 June
17 June
24 June
01 July		 08 July
15 July
22 July
29 July
05 Aug
12 Aug
19 Aug		 14 May
21 May
28 May
04 June
11 June
18 June
25 June
02 July		 09 July
16 July
23 July
30 July
06 Aug
13 Aug
20 Aug		 14 May
21 May
28 May
04 June
11 June
18 June
25 June
02 July		 09 July
16 July
23 July
30 July
06 Aug
13 Aug
20 Aug		 14 May
21 May
28 May
04 June
11 June
18 June
25 June
02 July		 09 July
16 July
23 July
30 July
06 Aug
13 Aug
20 Aug

Ecuador New Zealand Thailand  
14 May
21 May
28 May
04 June
11 June
18 June
25 June
02 July		 09 July
16 July
23 July
30 July
06 Aug
13 Aug
20 Aug		 13 May
20 May
27 May
03 June
10 June
17 June
24 June
01 July		 08 July
15 July
22 July
29 July
05 Aug
12 Aug
19 Aug		 13 May
20 May
27 May
03 June
10 June
17 June
24 June
01 July 		08 July
15 July
22 July
29 July
05 Aug
12 Aug
19 Aug 		   

Why would you be a suitable participant on ISV's Programs? (max 400 characters)
Date university classes end for summer Date university classes begin in fall
Hobbies/interests:
I am interested in:
6-day Fiji Island Excursion at the conclusion of the ISV Program in Australia or New Zealand.
One-week Galapagos Islands Excursion at the conclusion of the ISV Program in Costa Rica or Ecuador.
One-week Peru/Machu Picchu Excursion at the conclusion of the ISV Program in Costa Rica or Ecuador.
How to receive donations from sponsors in my community that will go towards offsetting the program cost.

   
 How did you find out about the ISV Program? (Please check all that apply and explain.)
Classroom Announcement Name of Announcer?  
Campus Student Rep Name of Representative?  
Professor / Teacher Name of Professor?  
Flyer / Poster What was the name on it, if any?  
Website, Social Network, Search Engine What site? (URL, Facebook, Google, etc.)  
Other Please explain:  
LIABILITY AGREEMENT: I VERIFY THAT ALL THE ABOVE INFORMATION IS CORRECT; I FURTHER AGREE TO ABIDE BY ALL THE LAWS OF THE COUNTRY I WILL BE VISITING INCLUDING, BUT NOT LIMITED TO, REFRAINING FROM ANY USE OF ILLEGAL DRUGS. I REALIZE THAT ISV REQUIRES EACH PARTICIPANT TO HAVE HIS/HER OWN MEDICAL AND TRAVEL/CANCELLATION INSURANCE WHICH WILL COVER THE PARTICIPANT WHILE IN THE COUNTRY OF TRAVEL AND AGREE TO SECURE SUCH INSURANCE PRIOR TO MY DEPARTURE TO MY FOREIGN COUNTRY. I HAVE READ, UNDERSTAND, AND AGREE TO ABIDE BY ALL THE POLICIES STATED IN ISV'S TERMS & CONDITIONS (SEE COPY ON THE ISV WEBSITE UNDER "TERMS & CONDITIONS" AT WWW.ISVONLINE.ORG).
Your Signature * Date INTERNATIONAL STUDENT VOLUNTEERS, INC.
ADDRESS: 
 4848 Lakeview Ave. Suite 100A
Yorba Linda, CA 92886
PHONE: (714) 779-7392
FAX: (714) 777-4647
EMAIL: isvcan@isvonline.org
    WEBSITE: www.isvonline.org

 
© 2008 International Student Volunteers. All rights reserved.