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2010-11 Student Programs AFS in India
OFFICE USE ONLY
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 (the Preliminary Application – this form) starts the process. It tells us that
you want to participate in the AFS experience and it indicates which programs and
countries you are interested in. When AFS receives this form, an initial prescreening will be done. If your application is approved, Part 2 (the Full Application)
will be given to you.
Please attach a
Step 2 (the Full Application) is essential as your answers help us further determine
your eligibility and suitability for an AFS experience. If you are finally selected for
AFS, some of the information you give in this Full Application (approx. 20 pages) will
be the first information provided to the host country and the host family. If you pass
this step, you will be informed and called to an Interview.
Step 3 (the Interview Stages) provides valuable input for AFS to make the final selections. A panel of AFS
volunteers will meet with you and interview and evaluate you on the basis of certain criteria. This gives you an
opportunity to learn more about AFS and to begin thinking about what you want to gain from an AFS experience. It
also gives us the opportunity to learn more about you and what you are looking for in an intercultural exchange
These Individual Interviews plus Home Visits or Family Interviews 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 Essay explaining why you want to travel to another country must be written in handwriting by the
applicant him/her self and attached to this Preliminary Application Form.
Good luck from AFS in India!
PLEASE FILL IN THE FORM IN ENGLISH AND PRINT IN BLOCK/CAPITAL LETTERS
Female Date of birth: Day _____ Month _______________________ Year ______
I am currently studying in (9th, 10th, 11th grade):____________________
Country of Birth _____________________________ Country of Citizenship:________________________
Name (First / Middle / Last) ____________________ _____________________ ____________________
Home Address (with Pin code):____________________________________________________________
Home Telephone or Person Contact’s phone (with STD code) ___________________________________
If you do not have an email address, please provide one from your family member or friend. This email is very important to
inform you about the status of your application, do not change it.
Important! 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 MUST OBTAIN one. DO
NOT LEAVE ANY BLANKS AND FILL THE FORM NEATLY otherwise you will be disqualified.
WRITE N/A OR A LINE WHERE DOES NOT APPLY TO YOU.
PLEASE, SUBMIT THIS APPLICATION TO THE AFS LOCAL CHAPTER.
Revised March 2009
B.: _________ Mother/female guardian Name (First / Last) _____________________________________ D. religion. please specify: _____________________ ______________________________________________________________________________________ Are you vegetarian? YES NO. Specify what you cannot eat: Beef Pork Fish Poultry Dairy/eggs Non – Halal meat Onion/garlic Root veg. vegetarian food and Halal meat are not always easy to obtain.) ___________________________________________________________________ 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.O. other (specify) _________________ Please explain why you cannot eat any of above ticked (Ex. In a host community. Fasts.O.:_________ Sisters (Name / D. While host families will usually try to accommodate your needs.O.B.B.B. etc. due to distance.)__________ ______________________________________________________________________________________ Note that in many countries. availability and costs access to places of worship. 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 .) ____________________________________________________________________ Brothers (Name / D.O. health.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. prayers. you may need to be flexible.
. and rate your fluency as fair. 8th-70%.10th. Date Passport expires:___________________________ HOBBIES/ FREE-TIME ACTIVITIES What do you do in your free time? __________________________________________________________ ______________________________________________________________________________________ Name any organizations or social services you are involved in ___________________________________ ________________________________________________________________________ List any special roles or achievements ___________________________________________ ________________________________________________________________________ Revised March 2009 3 . 1st UPC)______________________________________ Marks % in last 3 years (Example: 7th-80%. 9th. for what and when?_____________________________________ ______________________________________________________________________________________ Do you have any illness for which your take medication regularly/occasionally?________________________ If yes.Preliminary Application Form (Part 1) 2010-11 Student Programs AFS in India OFFICE USE ONLY AFS ID# SCHOOL/PUC INFORMATION (Where you are currently studying) School/PUC Name ______________________________________________________________________ School/PUC Address (Include PIN)__________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ School Telephone (Include STD Code)_______________________________________________________ Principal’s Name ________________________________________________________________________ School/PUC standard last completed? (Ex. Passport Number_____________________________ Date Passport was issued:___________________. 9th-80%)______________________________________ Extracurricular Activities at School/PUC_______________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ HEALTH INFORMATION Have you ever been hospitalized? If yes. describe_________ ______________________________________________________________________________________ LANGUAGE INFORMATION List all Indian languages and foreign languages that you speak/ understand/ write. (In parenthesis for each one)__________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Have you ever traveled within India? Where? When? __________________________________________ ______________________________________________________________________________________ Have your ever traveled abroad? Where? When? ______________________________________________ ______________________________________________________________________________________ Do you have a valid passport? Yes No If yes. describe _________________________________________________________________________ Do you have any medical (including mental) condition or disability. any allergies? If yes. good or excellent.
will you be instructed to complete the Full Application Form (Step 2)._________________ I have discussed with my parents that I am applying for an AFS Intercultural Program.+91-11-29841426 Only if you are short-listed from among the pre-applicants. Thank you and good luck! To read more about AFS India visit our website: www. Sometimes a week.org/India) YES. How did you know about AFS Programs? Please. NO. Lajpat Nagar II New Delhi 110024. Have you seen the AFS webpage? (www.Preliminary Application Form (Part 1) 2010-11 Student Programs AFS in India OFFICE USE ONLY AFS ID# ESSAY Write an essay of maximum 200 to 250 words on the subject “This is what I would like to be doing with my life ten to fifteen years from now.afs. _________________. Signature of Student_________________________ Signature of Parent ___________________________ Date _____________________________________ Date _______________________________________ To start the application process.9 (2nd floor).org. please submit this preliminary application to AFS in India at: AFS Intercultural Programs India M . Once a month. Write this essay in your own handwriting on a separate sheet of paper and enclose it when submitting the preapplication form.+ 91-11-4100 4878 / 79 Fax . explain:_________________________________________ _______________________________________________________________________________ ACKNOWLEDGEMENT AND DECLARATION OF INTENT COUNTRIES APPLIED FOR: ________________. India Tele . NO.in Revised March 2009 4 . Once a week. How often you use internet? Everyday. Use paper A4 size (same as this application form) COMPUTER & INTERNET Do you have access to a computer at school and/or home or other :_______________________ Do you know how to use the electronic mail (email)?: YES.” Use black ink.afs. The essay may be written in any language.
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