Exchange Application

Please fill out form and press the “submit” button. You need to provide us with your contact information. Email address is preferred, but phone number will work. If you do not hear from us within two weeks, please contact us at: info@strawberryfields.org.

If you are in need of financial assistance to participate in this activity, in addition to your application form, please send a letter or e-mail to the CCE committee: info@strawberryfields.org with your name, address, the amount of assistance you may require, and brief description of your needs. Your information will remain confidential.

CCE 2012 Program Application Form

First Name*
Last Name*
Birthdate*
Phone number
Email
You are...
Street Address*
City*
Postal Code
State/Province
Country*
Emergency Phone Number*
Passport Number and country of issue*
Please specify which programs you are interested in...
Blood type, allergies, medicines and other medical conditions
Touring Skills: Ability to camp
Social Agility: English Language skills
Other Language Skills
Are you a smoker?
Do you have experience traveling with a group?
Other group experience:
Your reasons to participate in CCE program.