Application Form

 

Country

Last Name

First Name

Current Address

Current country City&State

Current Phone

Permanent Address & City

Permanent Country &P. Code

Permanent Phone

Email Address

Gender & Age

Emergency Phone & relation

Emergency E-Mail

Program Type

Location

Start Date

End Date

 

Applications Submit including the items listed below, either by regular fax, email, or regular mail. Please submit all items at the same time. If you will be faxing or emailing your paperwork, you may send your application fee separately. However, without receipt of your USD $80 application fee, we can only hold your application on file for 25 business days. This fee will be credited toward the cost of your program.

Application package must include:

1. Internship Application form

2. Resume

3. USD $80 application fee. (Money order, international cashiers check or account deposit) This will be credited to your program fee. To submit payment via Bank transfers please use the following addresses information :

 

Bank Name: BANCO PICHINCHA

Bank Address: Av. Amazonas 4545 y Pereira

Bank Phone Number: 5932 - 2981- 165

Beneficiary Account Number: 30244015- 04

Beneficiary Account Name: Mariana de Jesus Lara Benitez

SWIFT code: PICHECEQ.