PERSONAL INFORMATION Your name Your email Passport Number EDUCATION BACKGROUND Current School/Institution Field of Study Level of Education HEALTH DECLARATION Do you have Chronic diseases? Please specify any medical history we should be aware of: ADDITIONAL INFORMATION Next of Kin Next of Kin Phone Number Parents/Guardians Consent (if under 21 years): PROGRAM SPECIFIC QUESTIONS Why are you interested in participating in the Bridges program? What do you hope to gain from this cultural exchange experience? Have you had any previous international travel or cultural exchange experiences? If so, please detail.
