1.Name (as stated on Passport):

2.Address:

3.Phone(s):

4.Email:

5.Nationality:

6.Birth Date:

7.Profession or Field of Expertise (relevant to the project):

8.Degrees and/or relevant qualifications:

9.Number of days/weeks you aspire to be in service:

10.Do you have international travel experience?

11.What countries have you visited?

12.In those above countries, in what types of activities did you engage? 

13.Have you ever led any training workshops or given public presentations? If so, on what topics?

14.Will this be your first time in Peru?

15.Do you speak Spanish or Quechua? 

16.Are there particular places or activities that you would like to visit or engage in while in Peru which may be incorporated into your training itinerary? (please note that ACEA does not organize tourist excursions. Those should be done either prior to or after your time scheduled for trainings.)

17.Accommodations for the duration of your training program will vary depending on the remoteness of the training site. In some cases, the most expensive room in the whole village may cost $3.00 or less. In other cases, there may be a wider variety of accommodations available. For hotels, when hotels are available, what is your preferred price range (please coordinate with your other group members): per nite $10-$15, $20-$25, $40-$65, $70-$90, $100-up?

18.During the duration of your program, do you prefer to travel by public transportation or private car? Depending on the size of the group, a private vehicle with driver can range between $60.00 and $120.00 per day.

19.Do you have or have you had, any illness or condition affecting your heart, lungs, spinal column, bones, and/or mental or physical functioning? If so, please elaborate.

20.Please go to the below url and complete the Spanish competency exam.  While registering, the online service will prompt you for an email address to send your results.  Please use our below email address for that.  After our review we will forward your results to you. (Click here for Spanish Competency Exam)

21.With this questionnaire, please include your resume and several non-family references.

Please email all visiting trainer participant material to: susan@worldayni.org

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