The association of
Intercultural youth exchange /
Application For Cultural Program in Morocco
Please
Insert your photo here
(Obligatory)
A. Details of the applicant
Name
Street address
Postcode / City
Region / Country
Email / Website
Telephone / Telefax
Passport Number / Expiration
Date and place of birth / Gender
Occupation and Employer (if a student, please indicate school, field and level of study):
Person to be contacted in case of emergency (name, relationship, phone, fax, or e-mail):
B. Skills
Are you familiar with the Pottery technics?
Have you ever studied Pottery before?
If yes: / Period of study(inc.hrs/wk) / Institutiono / Course Level
How would you evaluate your Pottery skill?(Poor, fair,good,excellent)
Your painting&decoration?
If English is not your native Language, what’s your level?
Do you have any background in French? If so, what’s your level?
Prefered program start date
How long would you like to stay?
What are your goals in applying for our program?
C. Housing
Have you ever been in Morocco before? If so, when?
Will you require assistance in finding housing during your stay? / ( ) homestay
( ) good hotel [200+ DH/night]
( ) modest hotel [90-200 DH/night]
( ) cheap hotel [50-80 DH/night]
( ) apartment alone
( ) apartment to share with other students
If yes, please number your preferences:
Please indicate below any preference you have regarding housing and any special needs or requests that should be taken into consideration in arranging for your homestay or other housing options such as dietary restrictions, allergies, etc. (use additional page if necessary):
Special Health /Other Needs:
Free comment
Place and Date: / Signature:( Scaned for E-mail)
Jeunesse des Chantiers Marocains JCM, BP 775 Gueliz Principal, Marrakech, Morocco
Tel: +212 670962757
E-mail:
Ass. Jeunesse des chantiers Marocains Version valid as of 1 January 2010