APPLICATION FORM - MILL September 2008
Name/s
______________________________________________________
Address
______________________________________________________
Phone____________________ Mobile
______________________
Email
__________________________
Date of birth _____________________
(Limited accommodation may be available – please contact us if required)
Lunch can be provided at a cost of $5 per person. Please indicate the number of people requiring lunch on any day:
Monday ___ Tuesday ___ Wednesday ___ Thursday ___ Friday ___
Any
special dietary or disability needs:
_______________________________
First language: ___________________________
Other language/s known:
______________________
Expected Country of Service
(if known):___________________________________
Language/s you expect to learn on the field:
__________________________________________
Expected role/s on the field (if known):
__________________________________________
Sending agency (if applicable): ______________________________________
Complete these sentences:
"Learning another language is like.... ______________________________________
_________________________________________________________________
"When I think about language learning I …. __________________________________________
_________________________________________________________________
Signed _________________________
Email completed form to us here
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