Youth Ambassador Program Application

Student Contact Information

Your full legal name as it appears on your passport*

First Last

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone

Email Address*

Parent/Guardian Contact Information

Parent/Guardian #1 Name*

First Last

Parent/Guardian #1 Address*

Parent/Guardian #1 Email*

Parent/Guardian #1 Phone*

Parent/Guardian #2 Name

First Last

Parent/Guardian #2 Address

Parent/Guardian #2 Email

Parent/Guardian #2 Phone

Diversity Questions

Name of your high school*

Current grade*

Expected Graduation*

Gender*

Ethnicity with which you identify (Optional)

Travel Experience

Do you have a valid passport?*

If not, will you be able to apply for a passport?

Will your passport be valid for at least 6 months after the trip end date?*

Are you a citizen or a permanent resident with a green card?*

Do hold a refugee status? (If yes, you will need ample time to acquire a travel document, and must apply not later than April).*

Please list any allergies.

Supplemental questions

What are the dates for your Spring Break?*

When will you get out of school for the summer?*

When does you start school in the fall?*

Do you foresee any complications with the YAP dates and your schedule i.e. sports, clubs, job?*

Essay Questions

What are main reasons why you are applying to YAP?*

What do you most hope to learn/experience?*

Do you consider yourself to have leadership potential? Explain.*

What personal experiences or interaction have you had with other faiths, cultures, and ethnicities, if any?*

How will your community (family, school, local) benefit from your participation?*

In which ways are you interested in the Middle East, International Relations, Religious or Interfaith Studies, Intercultural Studies, Conflict Resolution, Peace Studies and other related topics?*

Please use this space to add anything else you would like us to know.

Teacher or Academic Reference Information*

Please provide the contact information for at least one teacher or academic reference that we may contact.

Youth Ambassador Program Application

Student Contact Information

Parent/Guardian Contact Information

Diversity Questions

Travel Experience

Supplemental questions

Essay Questions

Contact us

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