Organization name: * Country: * Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and/or Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British lndian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfork Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Republic of Kosovo Republic of North Macedonia Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbarn and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States minor outlying islands Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (U.S.) Virigan Islands (British) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Mailing address: Please list in line order as to be written on a mailing envelope. Line 1: * Line 2: * Line 3: Line 4: Organization website: Director/President name: * Email: * Phone: * J1 Visa placement contact person: * Email: * Phone: * Skype: Emergency phone number (This number must be available 24 hrs/day, everyday): * What are your fees for a 5 month program charged to natural families?: What are your fees for a 10 month program charged to natural families?: As a potential partner of Terra Lingua USA it is important that we understand your objectives. Please answer the following questions: Please describe your organization’s mission: How many years have you been organizing student exchange?: Indicate the average number of students you send for the following programs each year: J1 Visa: Indicate the number of students you might send for the following programs: J1 Visa: Do you hold any certifications or accreditations: How do you intend to market our programs: How do you screen your students for programs: Please list U.S. organizations you have worked with: Please provide two U.S. organizations and contact names we can reach for a reference: Organization name: Years in partnership: Average number of students sent: Contact person: Contact email: Contact phone: Organization name: Years in partnership: Average number of students sent: Contact person: Contact email: Contact phone: