Application form for Adult Participants To apply for this opportunity you must be graduated, an academic, or a professional and have previous knowledge of the English language. This application is not for undergraduate students. There are only 10 spaces available in the group for adults and we anticipate a competitive application process, therefore please be thorough in your application. Please provide the following information in English. Submit your completed application via email by 12:00 on Friday August 22nd, 2014. For questions, please contact Michelle Mirabella, Coordinator of the American Corner UDP, at american.corner@udp.cl or 56- 2-26768074.

Name:

E-mail:

Secondary e-mail:

Local phone #:

Additional phone #:

Hobbies and interests:

Relation with UDP:

Area of study (if applicable):

Occupation:

Institution where you work:

What is your position/job (Be as specific as possible.):

Previous knowledge of English (Be as specific as possible):

Why do you wish to participate in the conversation group? (Provide a detailed response.)

Thank you for completing your application for the American Corner UDP Conversation Group for adults. The receipt of your application will be confirmed by email and decisions will be made by Friday, August 29th 2014.

American Corner Universidad Diego Portales (UDP)

Conversation Groups for practicing English January 2013