Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Web Site First Name * Last Name * Email Address * Confirm Email Address * Mobile Number Birthday * Home Address Home Address1 Home Address2 City State Zip Code Country What is your country of citizenship? What school, if any, do you attend? Check all that apply: I'm currently an undergraduate student I have graduated from college I'm currently a graduate student I'm currently taking a gap year in my formal education I have some professional internship experience I am a working professional I have a valid passport with 6 months left before expiration I have traveled abroad with family I have traveled abroad independently I'm a committed life-long learner In 250 words or less, tell us about your educational experience and your professional goals: In 250 words or less, tell us something about your interests, hobbies, and free-time activities: Briefly share both your best and worst travel experiences Please provide us with a profile photo Why are you interested in this program? How will you contribute to create value for your peers during the experience? How will this program fit with your academic plans? How do you contribute to a group? What do you expect to get out of this experience? Briefly, what do you know about Italy? What skills, strengths, and characteristics make you a strong applicant? How will you positively represent your school, your family or your community while abroad? What questions do you have for us? Do you need help fundraising for the Designer Experience in Verona?