Non U.S. Application

TO APPLY:

Review the AHA Website
Complete all items on this application
Application will not send with out attaching your photo, motivation letter, and CV.

After AHA receives the application and attached documents, the applicants will be notified of the results within 3 to 5 business by e-mail.

1. Name (as it appears on passport):
Surname (family name):
First Name:
Middle Name:

2. How did you hear about us?
Recruiting Partner
Recruiting Partner's Company:
Recruiting Partner's Email: (no hotmail accounts):
Recruiting Partner's Name:
Resort Referral
Resort Name:
University
University Name:
Internet
Other

3. Address where any documents should be sent (PO BOXES not accepted)
Street:
City:
State/Province:
Country:
Postal Code:
Phone:
Mobile Phone:
Email (no hotmail accounts):

4. Biographical Information:
Date of Birth:
City of Birth:
Country of Birth:
Country of Citizenship:
Country of Permanent Residency:
Country where passport is issued:
Passport Number:
Passport Expiration Date:

5. Post Secondary Educational Experience:
Education:	None 4-year University 2 year vocational or trade school
Course of Study:
Did you Graduate?	Yes No
If yes, when:
Anticipated Graduation Date:
Level of Degree:

Name of Institution:
Advisor:
Advisor's Email Address:

6. Previous Visas
Have you been to the USA before?	Yes No
If yes, when?

If other than a tourist, what visa?
Other (specify):

7. Criminal Background:
Have you ever been convicted of a crime? If yes, please explain below:

9. Work Related Experience:
Employer:
Start Date:	Year:
End Date:	Year:
Position:
City:
Country:

Employer:
Start Date:	Year:
End Date:	Year:
Position:
City:
Country:

10. Other Information:
Position Desired:
Month Available:
Duration of Program:
Are you an AHA graduate?	No Yes

11. Required Documents
Photo:
Motivation Letter:
CV:
Requirements: Photos must be saved as JPEG (".jpg/.jpeg") or GIF (".gif") format and less than 3MB. If your photo exceeds 3MB it must be resized before uploading. Try Infranview, a free program to help you resize your photos. Documents must be saved as Microsoft Word (".doc"), Portable Document Format (".pdf"), Plain Text (".txt") or Rich Text (".rtf") format and less than 3MB.

All trainees in the program must be covered by accident and health insurance for their entire length of training in the United States.

By checking this box, I hereby certify that the information here is true and accurate to the best of my knowledge.
For all intents and purposes, this is the electronic equivalent of your signature.

8. Health Background:
Please check all conditions that you have or previously had
	Allergy (if serious)	Asthma
	Cancer/Tumors	Chicken Pox
	Convulsive Disorder	Diabetes
	Dyslexia	Eating Disorder
	Eczema	Hepatitis
	Measles	Migraine Headaches
	Mumps	Physical Handicap
	Psychological Disorder	Rheumatic Fever
	Rubella	Scarlet Fever
	Substance Abuse	Thyroid Disease
	Ulcer	Urological Problems
	Whooping Cough