Request for Counseling

Email*

First Name*

Last Name*

Phone Number*

Student's Gender*

Student's Age*

Student's Date of Birth*

Nationality*

Name of school currently attended*

Desired timing and duration of travel*

Please be as specific as possible. e.g. 2-3 weeks between July 15 and August 31, 2023

Student's School Year/Grade*

Study abroad program of interest*

Purpose of Study Abroad*

Past international travel (country, city, year of travel, length and purpose of stay)*

E.g. San Diego, USA, 2019, 2 weeks, homestay

English level (Eiken, TOEFL, TOEFL Jr., iTEP SLATE, etc.)*

Maximum budget*

Please tell us about the student's personality*

Have any special requests?*

If you have any questions you would like to ask in advance of counseling, please fill in the form.*

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