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Published by: Deyzan Husain on Mar 17, 2011
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If you have an email address, this information must be given now, as much of our
communication is by email. If you do not have an email address, YOU MUS O!"I# one. $O
#O %&"'& "#Y !%"#(S "#$ )I%% *& )O+M #&"%Y otherwise you will be dis,ualified.
-+I& #." O+ " %I#& -*&+& $O&S #O "//%Y O YOU.
/%&"S&, SU!MI *IS "//%I0"IO# O *& ")S %O0"% 0*"/&+.
Preliminary Application Form (Part 1)
2010-11 Student Programs AFS in India
AFS in India has a 3-step application process. Great care is taken to match your
interests and needs with the program, the country and the host family that are right
for you. All Items must be filled in properly.
Step 1 (t!e Preliminary Application this form! starts the process. It tells us that
you want to participate in the AFS e"perience and it indicates which programs and
countries you are interested in. #hen AFS recei$es this form, an initial pre-
screening will be done. If your application is appro$ed, %art & 'the Full Application!
will be gi$en to you.
Step 2 (t!e Full Application) is essential as your answers help us further determine
your eligibility and suitability for an AFS e"perience. If you are finally selected for
AFS, some of the information you gi$e in this Full Application 'appro". &( pages! will
be the first information pro$ided to the host country and the host family. If you pass
this step, you will be informed and called to an Inter$iew.
Step " (t!e Inter#ie$ Stages) pro$ides $aluable input for AFS to make the final selections. A panel of AFS
$olunteers will meet with you and inter$iew and e$aluate you on the basis of certain criteria. )his gi$es you an
opportunity to learn more about AFS and to begin thinking about what you want to gain from an AFS e"perience. It
also gi$es us the opportunity to learn more about you and what you are looking for in an intercultural e"change
)hese Indi$idual Inter$iews plus *ome +isits or Family Inter$iews lead to a merit-based national ranking of all
applicants and to a selection of finalists that will be offered a chance to participate in an AFS program.
A one page ,ssay e"plaining why you want to tra$el to another country must be written in handwriting by the
applicant him-her self and attached to this %reliminary Application Form.

%ood luc& 'rom AFS in India
P()AS) FI(( I* +,) F-./ I* )*%(IS, A*D P.I*+ I* 0(-1231API+A( ()++).S
P).S-*A( I*F-./A+I-*
.ale Female /ate of birth0 /ay 11111 .onth 11111111111111111111111 2ear 111111
I am currently studying in '3
, 4(
, 44
5ountry of 6irth 11111111111111111111111111111 5ountry of 5iti7enship0111111111111111111111111
8ame 'First - .iddle - 9ast! 11111111111111111111 111111111111111111111 11111111111111111111
*ome Address 'with %in code!0111111111111111111111111111111111111111111111111111111111111
*ome )elephone or %erson 5ontact:s phone 'with S)/ code! 11111111111111111111111111111111111
,mail address11111111111111111111111111111111111111111111111111111111111111111111111111
If you do not ha$e an email address, please pro$ide one from your family member or friend. )his email is $ery important to
inform you about the status of your application, do not change it.
;e$ised .arch &((3 4
%lease attach a
#ote that in many countries, due to distance, availability and costs access to places of worship,
vegetarian food and *alal meat are not always easy to obtain. -hile host families will usually try
to accommodate your needs, you may need to be fle1ible.
Preliminary Application Form (Part 1)
2010-11 Student Programs AFS in India
FA/I(4 I*F-./A+I-*
8ames and Ages of parents or guardian and siblings with whom you li$e0
Father-male guardian 8ame 'First - 9ast! 111111111111111111111111111111111111111/.<.6.0 111111111
.other-female guardian 8ame 'First - 9ast! 1111111111111111111111111111111111111 /.<.6.0111111111
Sisters '8ame - /.<.6.! 11111111111111111111111111111111111111111111111111111111111111111111
6rothers '8ame - /.<.6.! 1111111111111111111111111111111111111111111111111111111111111111111
/oes anyone else li$e at home with you= 2,S 8< #ho= ;elationship= Ages=
*as anyone in your family e$er participated in an AFS program= 8ame 1111111111111111111111111111
;elationship to you 1111111111111111111 5ountry1111111111111111 2ear111111111111111
#hat religion are you0 *indu Islam >ain Sikh %arsee 5hristian <ther011111111111111111
/o you need a access to a place of worship when abroad= If yes, please specify0 111111111111111111111
Are you $egetarian= 2,S 8<. Specify what you cannot eat0 6eef %ork Fish %oultry
/airy-eggs 8on *alal meat <nion-garlic ;oot $eg. other 'specify! 11111111111111111
%lease e"plain why you cannot eat any of abo$e ticked ',". Fasts, prayers, religion, health, etc.!1111111111
In a host community, are you willing to eat=0 6eef %ork Fish %oultry /airy-eggs +egetarian
Father:s occupation 111111111111111111111111/esignation0111111111111111111111111111111111
5ompany name0111111111111111111111111 %hone0 11111111111111111111111111111
.other:s occupation 111111111111111111111111/esignation011111111111111111111111111111111111
5ompany name0111111111111111111111111 %hone0 11111111111111111111111111111
;e$ised .arch &((3 &
Preliminary Application Form (Part 1)
2010-11 Student Programs AFS in India

S1,--(3P51 I*F-./A+I-* (W!ere you are currently studying)
School-%?5 8ame 1111111111111111111111111111111111111111111111111111111111111111111111
School-%?5 Address 'Include %I8!1111111111111111111111111111111111111111111111111111111111
School )elephone 'Include S)/ 5ode!1111111111111111111111111111111111111111111111111111111
%rincipal:s 8ame 111111111111111111111111111111111111111111111111111111111111111111111111
School-%?5 standard last completed= ',". , 3
, 4
.arks @ in last 3 years ',"ample0 A
-B(@, B
-A(@, 3
,"tracurricular Acti$ities at School-%?51111111111111111111111111111111111111111111111111111111
,)A(+, I*F-./A+I-*

*a$e you e$er been hospitali7ed= If yes, for what and when=1111111111111111111111111111111111111
/o you ha$e any illness for which your take medication regularly-occasionally=111111111111111111111111
If yes, describe 1111111111111111111111111111111111111111111111111111111111111111111111111
/o you ha$e any medical 'including mental! condition or disability, any allergies= If yes, describe111111111
(A*%5A%) I*F-./A+I-*
9ist all Indian languages and foreign languages that you speak- understand- write, and rate your fluency
as fair, good or e"cellent. 'In parenthesis for each one!111111111111111111111111111111111111111111
*a$e you e$er tra$eled within India= #here= #hen= 111111111111111111111111111111111111111111
*a$e your e$er tra$eled abroad= #here= #hen= 1111111111111111111111111111111111111111111111
/o you ha$e a $alid passport= 2es 8o If yes, %assport 8umber11111111111111111111111111111
/ate %assport was issued01111111111111111111, /ate %assport e"pires0111111111111111111111111111
,-00I)S3 F.))-+I/) A1+I6I+I)S
#hat do you do in your free time= 1111111111111111111111111111111111111111111111111111111111
8ame any organi7ations or social ser$ices you are in$ol$ed in 11111111111111111111111111111111111
9ist any special roles or achie$ements ___________________________________________
;e$ised .arch &((3 3
Preliminary Application Form (Part 1)
2010-11 Student Programs AFS in India
#rite an essay of ma"imum &(( to &C( words on the subDect E)his is what I would like to be doing with my
life ten to fifteen years from now.F ?se black ink.
#rite this essay in your own handwriting on a separate sheet of paper and enclose it when submitting the pre-
application form. )he essay may be written in any language. ?se paper AG si7e 'same as this application form!
1-/P5+). 8 I*+).*)+
/o you ha$e access to a computer at school and-or home or other 011111111111111111111111
Do you know how to use the electronic mail (email)?: 2,S, 8<.
How often you use internet? ,$eryday, Sometimes a week, <nce a week, <nce a month.
Have you seen the AFS webpage? (wwwafsorg!"n#ia) 2,S, 8<.
*ow did you know about AFS %rograms= %lease, e"plain011111111111111111111111111111111111111111
A12*-W()D%)/)*+ A*D D)1(A.A+I-* -F I*+)*+
5<?8);I,S A%%9I,/ F<;0 1111111111111111, 11111111111111111,11111111111111111
I ha$e discussed with my parents that I am applying for an AFS Intercultural %rogram.
Signature of Student1111111111111111111111111 Signature of %arent 111111111111111111111111111
/ate 1111111111111111111111111111111111111 /ate 111111111111111111111111111111111111111
+o start t!e application process9 please submit this preliminary application to AFS in India at0
AFS Intercultural Programs India
M - 9 (2nd floor), Lajpat agar II e! "el#i $$%%2&, India
'ele - ( 9$-$$-&$%% &)*) + *9 Fa, - (9$-$$-29)&$&2-
<nly if you are short-listed from among the pre-applicants, will you be instructed to complete the Full Application
Form 'Step &!. )hank you and good luckH
To read more about AFS India visit our website: www.afs.org.in
;e$ised .arch &((3 G

Specify what you cannot eat: Beef Pork Fish Poultry Dairy/eggs Non – Halal meat Onion/garlic Root veg.:_________ Sisters (Name / D. While host families will usually try to accommodate your needs. health. In a host community.)__________ ______________________________________________________________________________________ Note that in many countries.Preliminary Application Form (Part 1) 2010-11 Student Programs AFS in India OFFICE USE ONLY AFS ID# FAMILY INFORMATION Names and Ages of parents or guardian and siblings with whom you live: Father/male guardian Name (First / Last) _______________________________________D.O.O. please specify: _____________________ ______________________________________________________________________________________ Are you vegetarian? YES NO.O. due to distance. availability and costs access to places of worship.B. religion.) ____________________________________________________________________ Brothers (Name / D. prayers.O. other (specify) _________________ Please explain why you cannot eat any of above ticked (Ex. vegetarian food and Halal meat are not always easy to obtain. you may need to be flexible.B.B.: _________ Mother/female guardian Name (First / Last) _____________________________________ D.B.) ___________________________________________________________________ Does anyone else live at home with you? YES NO Who? Relationship? Ages? ______________________________________________________________________________________ ______________________________________________________________________________________ Has anyone in your family ever participated in an AFS program? Name ____________________________ Relationship to you ___________________ Country________________ Year_______________ What religion are you: Hindu Islam Jain Sikh Parsee Christian Other:_________________ Do you need a access to a place of worship when abroad? If yes. Fasts. are you willing to eat?: Beef Pork Fish Poultry Dairy/eggs Vegetarian Father’s occupation ________________________Designation:_________________________________ Company name:________________________ Phone: _____________________________ Mother’s occupation ________________________Designation:___________________________________ Company name:________________________ Phone: _____________________________ Revised March 2009 2 . etc.

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