Registration for the 2008 LearnServe Program

Registration is only open to those who have been invited by CIE.
If your school is not yet involved with CIE and you would like it to be, please contact director@cie-wis.org.

All fields are required.

Part I: Personal Information

Program:

Spanish level:

Teacher Student

School name:

First name:

Last name:

Gender: Male Female

Age: Grade level:

Passport name:

Passport #:

Street address:

City:

State: Zip:

Phone:

Cell phone:

Email:

I require financial aid:

Part II: Parent/Guardian

Name:

Work phone:

Cell phone:

Email:

Part II: Teacher Information

Subject:

Grade level:

Years teaching:

Principal:

Emerg. contact:

Contact phone:

Part III: Commitment

Why do you want to be in this program? (3-5 sentences)

What skills, background, and/or interest do you bring to the program?

Please list any previous travel experiences:

By checking this box I indicate that I have read the commitment agreement and agree to follow its requirements.

CIE at WIS

Center for International Education

Registration for the 2008 LearnServe Program

Part I: Personal Information

Part II: Parent/Guardian

Part II: Teacher Information

Part III: Commitment