Contact Information
First Name:
Last Name:
Email:
Region:
What would you like from CCUSA?
Would you like someone to call you to discuss the programs that you have read about and are nor interested in?
Would you like someone to send you our general promotional flyer or to receive updates via mail?
Do you have specific questions about the program you would like answered over email?
Phone:
Mobile:
Address line 1:
Address line 2:
City:
State:
Postal Code:
Country:
Questions:
Where did you hear about CCUSA?
--CCUSA Staff--
--Consulate--
--Friend--
--Info Meeting / Presentation--
--Internet--
--Job /Careers Fair--
--Magazine--
--Newspaper--
--Other--
Other
--Poster--
--Radio--
--Teacher / Lecturer--
--Travel Agent--
--TV--
--University--
--CCUSA Staff--
--Consulate--
--Friend--
--Info Meeting / Presentation--
--Internet--
--Job /Careers Fair--
--Magazine--
--Newspaper--
--Other--
Other
--Poster--
--Radio--
--Teacher / Lecturer--
--Travel Agent--
--TV--
--University--
Other:
Programs of Interest
Please select the programs you are interested in form the list below. Some programs may be offered by multiple offices. You can freely choose which office to submit your inquiry to.
CCUSA New Zealand
PO Box 302 204 NHMC
Dominion Road
0751
Auckland
New Zealand
P:+64 9 870 4655
Fax:
Working Holiday USA
Work UK
Work Adventures Canada
Volunteer Adventures Abroad
Camp Counselors Russia
Intern USA
Work Experience USA [Winter]
Practical Training USA
Camp Counselors USA
Camp Counselors UK
Camp Counselors Canada
Intern Adventures Abroad
By submitting this inquiry you will be automatically added to the CCUSA Newsletter recipient list.
