Conversation Partner Application

Name

Exact Mailing Address

(As it should appear on
mailing label)

E-mail Address

Area Code & Phone Number

Gender

Male    Female No preference

Country of Birth

Cultural Affiliation

How long have you lived in the US?*

Languages you speak and level of proficiency:

What is the best time to meet on a weekly basis?

Day(s)

To select multiple days, hold down the CTRL key and then use you mouse to select each day you are available

Time(s)

To select multiple days, hold down the CTRL key and then use you mouse to select each day you are available

What gender partner do you prefer?

Male    Female

School & Field of Study

Level of Study
(BS, MS, PhD)

Anticipated Granduation Date

Department

Position