Long Term Work Exchange2009 Scholarship ProgramShould you have questions, please contact Jennifer Brooks at 973-948-5200. We look forward to receiving your application!
Long Term Work Exchange Application Form 2009Name: __________________________________________________________________ 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 as of January 1, 2009) 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_________________________________________ |
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