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Barbados June 2023 application
* Indicates required question
Email
*
Your email
Name as it appears (or will appear) on passport/ Nombre oficial en el pasaporte
*
Your answer
Passport number/ número de pasaporte
Your answer
Country of Issue of passport/ Nombre del país emisor del pasaporte
Your answer
Frequent Flyer/Travel Rewards # for American Airlines and Delta (if you have one)/número de viajero frecuente o recompensas de viaje para American Airlines (si lo tine)
Your answer
Date of birth/fecha de nacimiento
*
MM
/
DD
/
YYYY
Place of birth/ ciudad y país de nacimiento
Your answer
Date passport was issued/ fecha de emisión del pasaporte
MM
/
DD
/
YYYY
Date passport expires/fecha de la expiración para el pasaporte
MM
/
DD
/
YYYY
Home address/dirección de su domicilio
Your answer
Telephone (home)/número de teléfono de casa
Your answer
Telephone (cell)/número de teléfono de celular
Your answer
Gender (for airline ticketing purposes)/Genero (necesario para el pasaje aereo)
*
Female
Male
Prefer not to say
Other:
I prefer my nickname (list here)/Apodo(s) (si lo tenga)
Your answer
Number of credit hours completed (if college student)/Numero de horas de credito completadas (para estudiantes universitarios)
Your answer
Expected graduation year/año de graduación
Your answer
Emergency contact- Relation to participant/ Contacto de emergencia - Relación con el alicante
Your answer
Emergency contact First Name/primer nombre del contacto de emergencia
Your answer
Emergency contact Last Name/apellido del contacto de emergencia
Your answer
Emergency contact address/dirección del domicilio del contacto de emergencia
Your answer
Emergency contact Telephone (home)/número de teléfono del contacto de emergencia
Your answer
Emergency contact Telephone (cell)/número de celular del contacto de emergencia
Your answer
Emergency contact Telephone (work)/número de trabajo del contacto de emergencia
Your answer
Emergency contact E-mail Address/email del contacto de emergencia
Your answer
T-shirt size/talle de blusa
XS
S
M
L
XL
XXL
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Do you have any food allergies or other diet requirements (e.g. vegetarian)?/ Tiene alguna alergia de comida o restricciones dieteticas?
Your answer
Do you have any other allergies (medication, pets/animals, etc.) that we should be aware of?/¿Tienes laguna otra alergia que son importantes para el viaje?
Your answer
Do you have any physical or medical condition that we should consider?/¿Tienes condiciones fisicas o medicas que necesitemos saber?
Your answer
Do you have any medications that you routinely take?/¿Toma alguna medicación actualmente?
Yes/Si
No
Clear selection
Any additional medical information to note?/¿Hay alguna otra información medica importante?
Your answer
Is English your first language?/¿Es ingles su primer idioma?
Yes/Si
No
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Please list any other languages and proficiency/ ¿Hablas o tienes competencias en otros idiomas?
Your answer
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