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Apply

Preliminary Application

Given Name:
Surname:
M.I.

Program Placement Information:

What type of program(s) are you applying for?  Volunteer
 Intern
 Work

Please list your top three choices below. You may either participate in all three (or more), or list extra in case the program of your choosing is unavailable.

Desired Start Date

1.
2.
3.

Program Length

1.
2.
3.

Destination

1.
2.
3.

Personal Information:

Date of Birth (MM/DD/YY):
Age:
Sex:  Male
 Female

Mailing Address:

City & State:
Post Code:
Country:
Nationality:
Home Phone:
Mobile:
Email:
Occupation:
Promotional Code:
Reffered by:
Are you interested in being contacted by Different Drummer Travel about making additional travel arrangements?  Yes No
Where did you hear about Different Drummer Travel’s programs?
 Search Engine
 Social Networking
 Go Abroad
 Transitions Abroad Newspaper/Publication
 Friend/Relative
 Other

Please list your most recent educational and professional experiences:

School Name:
City, State, & Country:
Major/Concentration:
Diploma:  Yes
 No
Employer:
Dates Employed:
Position & Responsibilities:
Reason for Leaving?
Briefly explain which program(s) are you interested in and why?
I confirm I have read the Different Drummer Travel website and/or brochure thoroughly and agree to the terms and conditions set forth. I understand the $350 deposit will be deducted from my total program cost, and that $100 of the deposit is nonrefundable. I also understand that I have until 60 days prior to the program start date in order to cancel and still receive a full refund (less $100). Any cancellations requested less than 60 days out, will result in either a partial refund or no refund at all. Submitting an application through this website constitutes your electronic signature. Any record containing an electronic signature shall be deemed for all purposes to have been “signed” and will constitute an “original” when printed from electronic records established and maintained by Different Drummer Travel or its agents in the normal course of business. Upon Different Drummer Travel’s request, Participant agrees to manually sign or place Participant’s signature on any paper original of any electronic record that Different Drummer Travel provides to Participant containing Participant’s purported electronic signature.

 Accept

Applicant’s Signature:
Date

Non-discrimination Statement: Different Drummer Travel, LLC does not discriminate against an Applicant for Volunteer Placement on the basis of race, color, ethnicity, sex, religion, creed, national origin, socioeconomic status, age, disability, martial status or veteran status.