Where There Be Dragons : Apply

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Chances are, the less you've heard about a place, the more fantastic it will be to visit.

Where do YOU want to go?

*Denotes required field.

PERSONAL INFORMATION

Student's Full Name (as it appears on passport) *First Name:
Middle Name:
*Last Name:
*Course Name:
*If this is a semester program, please indicate fall or spring:
*Home Address:

*City:
State:
Country:
*Zip:
*Email:
*Home Phone:
Alternate Phone/Cell Phone:
*Birth Date:
*Age at start of course:
*Height:
*Weight:
*Sex:
*Citizenship:
*Passport #:
*Expiration Date:
*School Name:
*Current Grade in School:
School Mailing Address (if at boarding school):

*City:
*State:
*Zip:
*School Phone:
Father's First Name:
Father's Last Name:
Father's Email:
Father's Daytime Phone:
Father's Evening Phone:
Mother's First Name:
Mother's Last Name:
Mother's Email:
Mother's Daytime Phone:
Mother's Evening Phone:
*Student lives with:
*Name of Teacher Reference:
*Teacher Phone:
*Teacher Email:

QUESTIONNAIRE

The following information will help us to understand your needs and to better tailor the program to accommodate your interests. Thank you!

Please select a number rating for each of the below program elements, with 10 being "most important" and 1 being "not important."

*Finding yourself in a very remote, seldom, visited place:
*Living with a family:
*Trekking and wilderness exploration:
*Service Projects:
*Learning about global issues:
*Learning about global development issues:
*Working independently, on an independent study project, or internship:
*Language study:
*Comparative religion:
*Learning through experience:
*Learning through more traditional academic models (lectures, classes, etc):

Please answer the following short-answer questions to the best of your ability.

*What appeals to you about a Dragons program and what do you expect to gain from the program to which you've applied?:

*An exciting part of a Dragons program is the opportunity to travel with others. How would you describe your participation in a group?:

*Please tell us about any experience you've had that may have prepared you for this trip (e.g. other trips, classes, hobbies and interests)?:

Dragons courses are dynamic adventures in which itineraries change to accommodate student interests and the unique backgrounds of course staff. In consideration of this, please answer the following:

*a) Do you have concerns or issues traveling with a flexible itinerary? If so, please comment.:

*b) What aspect of the course appears to be the most appealing, and what would you not want to miss?:

*c) What aspect of the course is of least concern or interest?:

*Dragons students are put in unfamiliar, challenging environments where levels of comfort are seriously stressed. What challenges do you foresee while participating on this program? Please provide an example of when you were pushed out of your comfort zone, and how you responded.:

* I have carefully read the "General Terms and Conditions" and would like to make a reservation for the person listed above. I give permission for W.T.B. Dragons to use pictures of the course participant in promotional and/or educational publications and slideshows.