Apply NowAfter applying, you will hear from us soon. Name * First Name Last Name Email * Phone Country (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Birth Date * MM DD YYYY Gender * Male Female Other Preferred Session Dates * Please note apply for more than one if you are flexible otherwise only select one session. Session 1: May 24- June 12 Session 2: June 15- July 5 Session 3: July 6 - July 26 Session 4: July 27 - August 15 Session 5: August 17 - September 6 Citizenship and Passport Number * Passport Expiration Date * MM DD YYYY Name as it appears on passport * Emergency contact: Name and Relationship * Emergency contact number * Country (###) ### #### Emergency contact email Are you applying with anyone? If so, list friend(s) name(s) How did you hear about Likya Summer Scholars? * Were you referred to this program by someone? * What university/school do you attend or planning to attend? * What is your degree and are you currently studying? * What year are you? * Freshman Sophomore Junior Senior Graduate What interests you about the program? * What do you hope to gain from the experience? * Why do you think you would be a good candidate for this program? * Do you have any concerns? * Do you have any dietary needs? * Are you healthy and physically fit for walking around town and hikes. (please note: this is not an accessible tour). Do you have any medications you are bringing. Thank you!
