2020 GYV Virtual Registration

APPLICANT INFORMATION

Name

First Last

Date of Birth*

MM

DD

YYYY

Gender*

Name of Your School*

Your Current Grade*

Your Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Email*

Enter Email Confirm Email

Your Cell Phone

PARENT INFORMATION

PARENT/GUARDIAN 1 - Name*

First Last

PARENT/GUARDIAN 1 - Occupation

PARENT/GUARDIAN 1 - Business Phone*

PARENT/GUARDIAN 1 - Cell Phone

PARENT/GUARDIAN 1 - Email*

Enter Email Confirm Email

PARENT/GUARDIAN 2 - Name

First Last

PARENT/ GUARDIAN 2 - Occupation

PARENT/GUARDIAN 2 - Business Phone

PARENT/GUARDIAN 2 - Cell Phone

PARENT/GUARDIAN 2 - Email

Enter Email Confirm Email

How did you hear about the 2020 Virtual Global Youth Village?*

Please provide name of Individual/Referral Source

Youth APPLICANT QUESTIONS

Please answer ALL of the questions below.

1. What device or devices do you have available in your home to connect with the Global Youth Village virtual exchange program? Smartphone, tablet, desktop, laptop - list all that apply.*

2. Do you have reliable internet at home? If not can you go to a relative or friend's house safely to access the internet?*

3. Does your connection allow you to upload/download the following documents ?*

Text/Word Documents (.DOC, Excel, PDFs), Video Files (MP3, MP4, RAR), Picture Files (JPEG, TIFF etc.)

4. Please describe what qualities you feel a good leader should have and why?

PARTICIPANTS Signature*

I agree to follow the Global Youth Village guidelines

Date

MM

DD

YYYY

FOR THE PARENT - I understand that:*

• The 2020 Global Youth Village Virtual program is free of charge with limited spaces. It will be important for me to support my child's full participation in the 12 hours /week activities and to provide access to reliable internet.

Parent Signature*

First Last

Date*

MM

DD

YYYY

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