LOCAL ADDRESS:

DAYTIME PHONE:		EVENING PHONE:
BEST TIME TO CALL:		EMAIL ADDRESS:
US UNIVERSITY:		FIELD OF STUDY:
ANTICIPATED GRADUATION DATE:		MARITAL STATUS:	Single Married

What type of audio-visual aids of your country do you have?

records	tapes
photos	slides
national dress	crafts/art
money	stamps
maps	other

Do you have your own transportation?	Yes	No
Were you a Scout or Guide in your country?	Yes	No
Do you play a musical instrument?	Yes	No
Do you have it with you?	Yes	No

Best days/times to present

Have you spoken in front of groups/classes before? please explain

Please check if you would be willing to speak about these topics as they apply to your country.

educational system:	Yes	No
politics:	Yes	No
social customs:	Yes	No
geography:	Yes	No
history:	Yes	No
art/music:	Yes	No
rural/urban life:	Yes	No
religion:	Yes	No

Any additional comments: