INTERN INFORMATION FORM

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Global Treks and Adventures honors and protects your confidential information.

EXPEDITION LOCATION, MONTH/YEAR: _______________________________

FIRST NAME___________________________________________________________

MIDDLE NAME OR INITIAL_____________________________________________

LAST NAME____________________________________________________________

DATE OF BIRTH________________________________________________________

AREA OF STUDY (MAJOR/MINORS) _____________________________________

# OF CREDIT HOURS COMPLETED _____________________________________

PURSUING COLLEGE CREDIT FOR INTERNSHIP (YES/NO) _______________

T-SHIRT SIZE (MENS AND WOMENS SIZES AVAILABLE )__________________

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EMERGENCY CONTACT NAME_________________________________________

RELATIONSHIP TO CLIENT_____________________________________________

EMERGENCY CONTACT PHONE________________________________________