July 2025Interested in traveling? Fill out some info and we will be in touch shortly! We can't wait to hear from you! Name (as it appears on your passport) * (Last, Middle Initial, First) *IN THIS ORDER* Are you available to travel during the dates of the trip? * July 10-18, 2025 Yes No The total cost of the trip is $2550. Are you prepared to pay the non-refundable deposit of $500 by June 15th and the remaining balance by July 1st? * Payments can be made via this link on our website OR Payments can be made via PayPal to ada@theafricandiasporaalliance.org please include your Name - Travel Location - July 2025 in the Subject * Yes No What program are you interested in participating in? * Havana, Cuba Ghana Ethiopia Senegal Colombia Japan Costa Rica Are you a student or faculty member or other? * I acknowledge that flights are NOT included in the cost of trip * Yes, I acknowledge that I am responsible for my own roundtrip flight to and from Colombia No Date of Birth * MM DD YYYY Passport Number * Passport Expiration Date * MM DD YYYY Full Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### I prefer to have my own room at an additional cost Yes, I would like to pay an additional fee for my own room No, I'm fine with a roommate Roommate Preference First Name Last Name Food Allergies / Vegan/ Vegetarian/ etc. ? * Emergency Contact Information * First Name Last Name Tell us about yourself? * Who are you, where are you from, why you want to have an educational travel experience abroad? Explain in a few sentences why you are interested in this program? * Managing Expectations & Self Care * This trip covers both urban and rural environments. What kind of challenges do you expect to encounter in this experience? How do you intend to manage them? Thank you!
