In order to join the Global Crossroad program, please complete this form and submit it with a non-refundable registration fee of US$199 by credit card (Master Card or Visa). Our online application is highly secure as all confidential information (such as credit card numbers) is sent using the Internet security protocol known as "Secure Sockets Layer" or "SSL." This is a certification and encryption technology designed to make using your credit card as safe as possible on the internet. Please contact our webmaster, if you need more information about SSL. Global Crossroad Guarantees your placement, otherwise, we will refund your registration fee.

Please fill in ALL required fields.

Personal Information

First Name:
Last Name:
Province/Region (If non-USA):
Zip/Postal Code:
Male Female
Date of Birth(mm/dd/yy):
Phone (Home):
Phone (Mobile):
Emergency Contact
(required telephone number):
Applicants Email:
Please explain your primary motivation for participating in the Global Crossroad's volunteer program:
Please explain your educational, volunteering, and other experiences:
Are you in good health mentally and physically for traveling and volunteer work? Have you ever been convicted of a felony? Please explain any medical conditions or legal problems:

Trip Information:

Country of Choice :
First Priority Project :
Second Priority Project :
First Priority Start Date :
Second Priority Start Date :
Are you interested in participating in a 1-week language and immersion program?
(available in India, Nepal, Sri Lanka, Ghana, Kenya, Tanzania and Uganda)
Yes No
Are you interested in taking Spanish classes?
(available in Argentina, Costa Rica, Ecuador, Guatemala and Peru)
Yes No
Total Length of Stay in weeks (Including language & cultural program):
Are you interested in excursion package (travel, trek, safari, etc)? :
Yes No
Your Spanish Level? (Only Applicable to Latin American Countries):
If you have any concerns or questions please mention them here:
Are you traveling with other applicant? :
Yes No
Before submitting the registration fee, I acknowledge that I have thoroughly read all of Global Crossroad's terms and conditions. I hereby agree with all of the terms and conditions given by Global Crossroad. I understand everything that I have read, and I will fully abide by all of Global Crossroad's terms and conditions. I also agree to print one copy of the terms and conditions for my personal records.

» Please click here for the details of terms and conditions

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