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Short Term Program Information Form

AGENCY CONTACT INFORMATION

Address

SHORT TERM PROGRAM & TRAVEL DETAILS

Preferred Program Location

STUDENT DETAILS

HOMESTAY DETAILS

Please check the number of student(s) per homestay.

ITINERARY

Please select a Standardized Short Term Program
ESL & TOEFL Preparation Camp Session (select one or more)
For groups of 10 or more students, AHLI can create a customized itinerary of activities to meet your wants and needs. Please describe the activities you would like included in your program.

HEALTH AND ACCIDENT INSURANCE

Do you desire AHLI to purchase the required student insurance ($2 per day per participant)?