SUSPENDED FORM

First Name

Last Name

Full Name (as shown on passport)

Email

Preferred Name for Badge

Phone Number
(+country code-phone number)

Gender

Affiliation
Please write the NAME of your university, company, organization, etc. (ex. "Global Peace Foundation")

Title
(Job title, other leadership titles, etc.)

Participant Category

Professional‎ Graduate Student‎ Undergraduate Student‎ Other‎

Partnership Organization Code
If applicable, please write down the code given by one of the host organizations or co-sponsors of GPYE.

Date of Birth
(MM/DD/YYYY)

Country of Birth

Country of Citizenship

Passport or Drivers License #
This is for the security check to access government facilities; bring this same photo ID with you.
(Please add a letter P for passport or D for drivers license before the numbers. All foreigners must use passport numbers.)

Expiration Date of Passport or Drivers License (of above documents)
(MM/DD/YYYY)

English Proficiency

Native Fluent Conversational Limited

Visa Status

I am a host country citizen/resident‎‎ I already have a Visa for the host country‎ I will apply for a Visa‎ for the host country‎ I do not need a Visa for the host country‎

Funding Situation

I have sufficient funds to pay program fee. I need to raise funds for the program fee. ‎

Mailing Address (number & street)

City

State (Providence)

Postal Code

Country

Instant Messenger ID
Such as WhatsApp, WeChat, Skype, FB Messenger, BBM, KakaoTalk, Line, Viber, etc. You may put multiple IDs of different Messengers. Please indicate the App name after each ID, for example: gpye_2015 (Skype)

Emergency Contact Person - Full Name

Phone Number of Emergency Contact Person

Medical Conditions
Please list any medical conditions we should be aware of.

Personal Statement of Purpose:
(Briefly explain your interest in the GPYE and why you would like to be a part of it.)

Comments/Questions

How did you hear about Global Peace Youth?

Please upload a head-shot photo
For participants directory

Uploading, please wait...

Upload

Write a biography within 150 words.

Policy

I have read and agree with the policy.

Signature
Hold down your left mouse button and write your signature.

Clear