First Name:
*
Last Name:
*
E-mail:
*
Home Number:
Cellular Number:
*
University, Institute or College that you attend or from which you have recently graduated:
*
Major:
*
Graduation date:
*
Specific questions or comments:
Date of Birth:
*
Sex:
Male
Female
Civil Status:
Nationality:
Mailing Address:
*
Country where you reside:
*
Preferred Program:
*
Summer Program
Semester Program
Year-Long Program
Start Date:
January
May
June
September
Special Dates
Special Dates: (Please specify)
Start:
End:
Level of Spanish language capacities:
Basic
Intermediate
Advanced
Don’t Know
Field of Interest:
*
Art
Audiovisual Arts and Film
Business
Communications and Journalism
Development and Community
Education
Engineering
Environmental Studies
Hospitality and Tourism
Human Resources
Information and Communications Technology
Law and International Relations
Marketing
Medicine and Health
Other
Other Field: (Please specify)
How did you find out about InteRDom:
Please attach an updated copy of your resume:
Please attach a one-page cover letter detailing your interest in traveling to the Dominican Republic, the type of program and internship and/or research you would like to perform and your plan for how to fund the experience abroad: