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 Applicant InformationName *FirstLastDate of Birth *Email *Alternate EmailPhone *Permanent Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs your mailing address different from your Permanent Address? *YesNoAre you currently a student *YesNoFile Upload *You must have a passport valid 6 months beyond the end date of the program. (NOTE: If you do not currently have a passport, you may upload your driver's license instead.)Program & Travel PreferencesMusic Immersion / Travel & Tours *SelectMusic Immersion Ghana Tours How would you describe your diet?SelectVegetarianHalalOtherPlease indicate additional dietary restrictions:Health information 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 *Phone *Email *Primary Care Physician Name *Primary Care Physician Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrimary Care Physician phone number *NameContinue