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Competition Application Form

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Fill the form and join the competition!

Name:	:
Email:	:
Date of Birth:	:
Home Address:	:
Home & Cellular Phone:	:
Parent's Name:	:
Are you CosmoGirl subscriber?	:	Yes No
How do you get your CosmoGirl?	:
Where did you see the announcement?	:	Poster Magazine Radio
If you answered poster please state where you saw the poster	:
Have you been abroad?	:
Do you have any family who lives abroad?	:
Have you ever joined a summer program abroad?	:
If you answered yes please specify the country	:
Are you interested in learning other language beside English?	:
What is the possibility of you studying abroad?	:	After High- School After University No chance Don't know yet
What subject interests you?	:
Which country would you most likely to go for holiday program (e.g. summer school?	:	UK USA Australia Singapore Canada South Africa Others
Do you have other country of preference?	:
If you signed up for Summer Holiday in 2003, how much is your budget allowance?	:	1500 - 2000 2001 - 2500 2501 - 3000 >3000
Did you fill up this questionnaire with the your parents consent? (please be honest)	:

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