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STA - ISV Application Form



* Required Fields
Full legal name that will appear on your passport.

Last Name * First Name * Middle Name Nickname
Number & Street (while you're in school) * City * State * Zip * Country *
Number & Street (while you're not in school) City State Zip Country
Cell Phone # Email Address * Age * Gender *
MaleFemale
Home Phone # * Alternate Email Address Date of Birth *
Country of Birth * Country of Residence * Citizenship *
Emergency Contact 1 * Relationship * Phone # * Email Address
Emergency Contact 2 Relationship Phone Email Address
University University Major School Year  
Freshman Sophomore Junior
Senior Graduated Not a Student

Do you have any physical disabilities? *
If so, please explain.
 Yes     No
Have you been hospitalized in the last 12 months? *
If so, please explain.
 Yes     No
Do you have any allergies? *
If so, please explain.
 Yes     No
Do you take any prescribed medications? *
If so, please explain.
 Yes     No
Do you have any special dietary needs? *
If so, please explain.
 Yes     No

Do you speak Spanish? No Beginner Intermediate Advanced Fluent

T-Shirt size Small Medium Large X-Large XX-Large
 
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).
No Project Preference.
Conservation Project. (Australia, Costa Rica, Eastern Europe, Ecuador, New Zealand, and Thailand)
Social Community Development Project. (Costa Rica, Dominican Republic, Eastern Europe, Ecuador, and Thailand)

Please state full name of any students/friends you would like to be placed with, as well as the name of the university they attend:


Host Country: *
Number each country in order of 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.
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
 
Optional Excursions & Packages:
 
5-day Spanish Language/Latin Dance Lessons prior to the start of the ISV Program. (Costa Rica, Dominican Republic, Ecuador)
Optional Fiji 5-day Excursion at the conclusion of the ISV Program in Australia/New Zealand.
One-week Galapagos Island Excursion or Peru at the conclusion of the ISV Program in Ecuador.
How to receive donations from sponsors in my community that will go towards offsetting the cost of my Program.
Earning Academic Credit through Independent Study. Note: Students are responsible for designing an individualized course of Independent Study with their Academic Advisor.
 
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:
 
Travel experience:

 

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 TRAVEL/MEDICAL 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.

Your Signature
Date
    		International Student Volunteers, Inc.
4848 Lakeview Ave., Suite 100-A
Yorba Linda, CA 92886
Phone (714) 779-7392
Fax (714) 777-4647
E-mail info@isvonline.org

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*Additional taxes/fees: sample fares posted on www.statravel.com are per person and include the booking fee. Fares are subject to additional charges including, but not limited to: September 11th Security Fee of up to $5.00 for each flight segment originating at a U.S. airport; Passenger Facility Charges of up to $18, depending on itinerary; Federal Segment Fees of $3.60 per segment; and foreign and U.S. Government-imposed charges of up to $400 per international round-trip flight, depending on routing and destination. STA Travel is the world's largest student, youth and budget travel organization specializing in cheap flights, hotels and hostels, student travel insurance, and the International Student ID Card (ISIC).

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