Reality Tour Application - Global Exchange

Reality Tours Application

Title of Reality Tour you are applying for or group name:(Required)

Destination Country(Required)

Departure Date:(Required)

Name

Name(Required)

First Middle Last

As appear on your passport

Prefered Name:

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Cell Phone:(Required)

Email:(Required)

Date of Birth:(Required)

Birthplace:(Required)

Occupation(Required)

(if retired, please say from what field.)

Occupation (if retired, please state from what field)

Employer:

I identify my gender as:(Required)

Female

Male

Genderqueer/Non-binary

Other

Please share your pronouns:

Passport Information

Passport Issue Country(Required)

Passport number:(Required)

Place of issue(Required)

(State if issued in the U.S.)

Date of issue:(Required)

Date of Expiration:(Required)

Emergency Contact

Name:(Required)

Relation(Required)

Email:(Required)

Cell phone:(Required)

Accommodations

Most of our trip prices are for double occupancy. We cannot guarantee you a roommate. Single room accommodations require an additional fee. Please mark your preference. If this is a customized group please skip this question.

Do you want a single room?

Yes

Preferred roommate:

(If not requesting a single room)

Room Type

(if not requesting a single room)

Roommate gender preference

Tell us more about yourself

Why do you want to go to this destination?(Required)

What do you hope to learn from your Reality Tour? Are there topics, organizations or people that are of particular interest to you?

How will you share your learning experience when you return home?(Required)

Do you have any medical conditions that might affect your ability to participate in any aspects of this tour?(Required)

Please let us know so we can talk about how to make the trip as accessible as possible.

How did you hear about us?