Applicant Name *
Applicant Name
Home Address *
Home Address
Phone *
Phone
Date of Birth
Date of Birth
(If you are traveling from outside the United States) Do you have a passport? *
Have you ever traveled out of your home country before?
Do you have any medical, physical, or health concerns? Please select all that apply. *
Emergency Contact
Two Emergency Contacts are required
Phone Number *
Phone Number
Emergency Contact address *
Emergency Contact address
Name of Emergency Contact 2 *
Name of Emergency Contact 2
Phone Number *
Phone Number
Cell Phone Preferab
Home Address *
Home Address
Note:
NB: Applications will be reviewed before anyone is accepted. Because of limited space and resources, we cannot guarantee a space for last-minute applicants, but we will get back to you within 3 days regarding space availability.
Terms and Conditions *
Failure to disclose pertinent information regarding the applicant's current state of physical or mental health that may affect their experience or our ability to accommodate their needs is the responsibility of the applicant and not of The Way. If upon arrival to the program an applicant has a special need that was not disclosed and that The Way staff are not equipped to cater to, we reserve the right to dismiss that applicant at any point during the program and at their own expense. Please keep this in mind when submitting applications.