Language proficiency (for languages other than your native language):<br><br> Proficiency (Language, Years studied, Speaking):
[field id="field_121e157"]
How long have you been a volunteer and/or staff member?
[field id="field_22d08de"]
What positions have you held?
[field id="field_8d19330"]
Comments:
[field id="field_ee1a526"]
Have you ever served as a flight or bus chaperone with your organization or any other organization?
[field id="field_33611f6"]
If yes, please describe:
[field id="field_942bf2e"]
Are you an former exchange student or have you had experience living abroad ?
[field id="field_bc225bd"]
Health Information
Do you have any physical restrictions, impairments, or allergies that will limit your walking, sightseeing, or hinder your participation as a chaperone?
[field id="field_9593002"]
If yes, please explain:
[field id="field_a42f215"]
Do you have any physical restrictions, impairments, or limitation to sitting on a bus for 8-10 hours, with minimal breaks?
[field id="field_51411ba"]
If yes, please explain. How Many hours would you feel comfortable on a bus?
[field id="field_e98ff47"]
Do you have any dietary restrictions, including any which are for religious reasons or are self-imposed?
[field id="field_d06f1e5"]
If yes, please explain:
[field id="field_1959e1d"]
Please give detailed information concerning any medical impairment or disability that could affect your ability as a tour chaperone:
[field id="field_87aead8"]
Are you currently taking any medication or injections?
[field id="field_ea5999b"]
Yes If yes, please explain:
[field id="field_8023e58"]
General Information
Can you swim?
[field id="field_277fc48"]
T-shirt size:
[field id="field_abe7412"]
Participation Agreement
Which trip(s) are you interested in being a Chaperone? (Please specify trip(s) and dates)
Trip Name:
[field id="field_bd3c28d"]
Start Date:
[field id="field_9b32202"]
End Date:
[field id="field_61fdf7c"]
Can you arrive a day prior of start date of the trip if needed?
[field id="field_11dc990"]
Departure Airport Options:
1st Option:
[field id="field_dfaff32"]
2st Option:
[field id="field_215295d"]
certify that the foregoing information is correct. Misrepresentation of information could result in disqualification | I certify that the foregoing information is correct. Misrepresentation of information could result in disqualification.
