Interest Sheet

This Interest Sheet is to help you explore possible places to travel, interests to explore, and skills to develop on your gap year. We use it simply as a starting point for the initial free 90-minute brainstorming session. NOTE: Fields in RED are required. This information is confidential and for Interim's use only. It will not be distributed or sold to third parties.

Personal Information












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Education









Parent Contact Information

This section to be completed by applicants who are 21 and younger.





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Emergency Contact Information





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Medical Background

In order for us to make referrals that are best suited to you, we ask that you answer each of the questions below. This information is kept confidential.






Experiences & Interests




Geographic Locations

Please check all regions and specific countries that interest you.













Opportunities and Activities

Please check all boxes that interest you, regardless of your experience.















 



After you submit this Interest Sheet, please send us a recent photo or URL where we can find your picture: info@interimprograms.com



Ready to get started?

Fill out our Interest Sheet for a free 90-minute consultation or Contact Us with general inquiries.
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