Long Term Work Exchange

2008 Scholarship Program

Should you have questions, please contact Jennifer Brooks at 973-948-5200.

We look forward to receiving your application!

 

Long Term Work Exchange Application Form 2008

Name: __________________________________________________________________

Address: ________________________________________________________________

Home/Work Phone: _______________________________________________________

Cell Phone: __________________________  Email: _____________________________

* Workshop Titles: ________________________________________________________

_________________________________________________________________________

* Please Note: Participation in a specific workshop is conditioned on space availability.

(to view all 2008 workshops, click here)

Dates of the Work exchange residency: ________________________________________

Skills/Experience: __________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Emergency Contact:

Name:___________________________________ tel.______________________________

Address___________________________________________________________________

__________________________________________________________________________

Please provide two references:

1.   Name__________________________________________________________________

Telephone___________________E-mail_________________________________________

2.   Name__________________________________________________________________

Telephone___________________E-mail_________________________________________