AUSTIN – TAN CERCA DE LA FRONTERA / Austin – So Close to the Border

APPLICATION TO ATTEND DELEGATION TO THE MEXICAN BORDER.

Date of Delegation and Destination: _____________________________

 

 

 

 

 

 

 

 

REGISTRATION FORM

 

PERSONAL INFORMATION
Name:                    phone:

 

Email:

Address with zip:

(Passport required) Expiration date of your passport:

Your age and preferred gender identity:

Occupation, education, special areas of knowledge:

Health Information.   We ask for this information in case you have any special health needs or concerns.  Please check with your health care provider to be sure you have health coverage during your travels.  Please list any allergies, disabilities, health related conditions, or special dietary needs:

EXPERIENCE
Have you traveled to Mexico/Latin America/Caribbean previously? (Please describe

Spanish Language Ability:
Fluent__ Conversational____ Limited____ No experience_____

 

Why do you want to participate in this delegation?

Are you a member of a religious body, union, community or educational organization? (Please describe)

 

Emergency Contact:  Please give the name and contact information of someone who can act as an emergency contact.

Please send deposit $100 deposit to save your place, made out to ATCF and mailed to ATCF Attn: Cristina Gonzales, 3707 MLK Drive, Austin, TX 78721

Or contact the Executive Director, Leona Calvo at 512-474-2399

 

Click to read ATCF’s page about Delegations.