Heritage Student Foundation is seeking motivated, proactive and well-organized local coordinators who will be supervising students and host families in that local area. Heritage Student Foundation will review all application submitted and contact the applicant by email for the next registration procedure. Applicant’s privacy is the most imporant to us. Applicant’s information WILL NOT be disclosed. If the information given below turns out to be fraud or incorrect, the position will be canceled or suspended . All fields are required to fill out. First Name Last Name   (Use the registered name on driver license) Sex: Male Female Date of Birth Month 1 2 3 4 5 6 7 8 9 10 11 12 , Day; 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , SSN # -- Street Address City State   AL AK AZ AR CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NB NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip or Postal Code 1st Phone (ex:123-456-1111) 2nd Phone (ex:123-456-1111) Email (ex: abcd@hotmail.com) Ethnicity Asian/Pacific Islander Black White Hispanic Others Legal Status US Citizen Permanent Resident Non-Immigrant with legitimate visa Marrital Status : Married    Single    Divorced    Widowed (Single)    Separated Years of Residenc in the US  The 1st year of residence in the US or Canada (ex:1980) Level of Education   Graduate College High School Middle School Elementary School Name of Final School Current Occupation Level of English Native Advanced Intermediate Beginner Primary Language   English Arabic Chinese Czech Danish Finnish French German Greek Hebrew Indonesian Irish Italian Japanese Korean Latin Malay Mongolian Polish Portuguese Romanian Russian Serbian Slovak Slovenian Spanish Swedish Thai Turkish Ukrainian Uzbek Vietnamese Secondary Language (If any)   English Arabic Chinese Czech Danish Finnish French German Greek Hebrew Indonesian Irish Italian Japanese Korean Latin Malay Mongolian Polish Portuguese Romanian Russian Serbian Slovak Slovenian Spanish Swedish Thai Turkish Ukrainian Uzbek Vietnamese Previous Experience of Local Coordinator Yes No If yes, what organization have your worked with? If yes, list all schools you have been working with? Maximum distance to cover from your home. Select maximum distance to the areas from your home that you can supervise and coordinate.   20 mile 40 mile 60 mile 80 mile 100 mile 120 mile 140 mile 160 mile Up to 200 mile Comments   Please leave additional comments to introduce yourself.   How did you find Heritage Student Foundation? Word of Mouth   Student Agency   Google   MSN   Yahoo Other Web Site   Newspaper     Review & Confirm Please review and confirm information filled out and click check box below before you click Submit button     "I reviewed and confirmed that above information is true and correct"
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