Apply for the Experience Please complete the form below to email us. We will respond in 2-3 business days Immerse Yourself in Ghanaian Culture Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Email *Alternate EmailIs your mailing address different from your Permanent Address? *YesNoAre you currently a student *YesNoMusic Immersion / Travel & Tours *SelectMusic Immersion Ghana Tours How would you describe your diet?SelectVegetarianHalalOtherPlease indicate additional dietary restrictions:Please describe the general state of your health *SelectExcelentGoodFairPlease describe any general health concerns you have at this time: *Do you have any allergies? *YesNoHave you within the past 3 years been treated for any mental health issues? *YesNoEmergency Contact *FirstLastRelationship *Email *Primary Care Physician Name *Primary Care Physician phone number *EmailContinue
