Student Placement Questionnaire
Personal Information
Email Address
*
Program
*
-- Select a Program --
Microfinances
Modern Nature Visits and help out
Orphanage Visits And Help outs
School programs
School Teaching And Help programs
school visits
Placement Questions
1. What type of project would you like to do?
2. What is your motivation for doing this project?
3. What are your goals for the program?
4. What are your expectations from the program?
5. What is your background and experience related to this project?
General Questions
1. What qualities do you have that will help you adjust to a new environment?
2. What does culture shock mean to you?
3. Have you traveled outside your home country before? If so, where and for how long?
4. What languages do you speak and at what level (fluent, conversational, basic)?
5. Do you have any health conditions that may affect your placement?
6. Do you take any medications or have ongoing medical treatment?
7. Do you have any allergies that might affect your housing situation?
-- Select --
Yes
No
8. Do you have any food/meal restrictions?
-- Select --
Yes
No
9. Do you have any pet issues (allergies or preferences)?
-- Select --
Yes
No
10. Do you prefer a smoking or non-smoking environment?
-- Select --
Non-smoking
Smoking
No preference
11. How would you describe yourself?
12. What are your interests and hobbies?
Submit Questionnaire
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