Correspondence Match Educator Enrollment Form
Correspondence with a Peace Corps Volunteer can enhance your students' learning in almost any subject area. Peace Corps Volunteers serve in every region of the world, working at the grass-roots level. Their stories, projects, and experiences can provide U.S. students with in-depth, firsthand perspectives of global cultures - views not usually accessible through textbooks, films, or other media.
To take part in this unique opportunity, please fill out the form below. Feel free to share this program with your colleagues.
*Teacher:
* School:
* Address 1:
Address 2:
* City:
* State:
* ZIP Code:
* Work phone:
Alt. phone:
* Email:
* Grade level:
* Number of students:
Special Requests:
Although we will do our best to honor your requests, limiting your preferences will expedite the process.
Name of Volunteer (if known)
Volunteer Home
No preference
Country of service:
No preference
Central America
Caribbean
South America
Pacific Islands
Asia
Eastern Europe and Central Asia
North Africa/Middle East
Sub-Saharan Africa
Languages spoken:
No preference
French
Spanish
Areas of work
No preference
Education
Health
Community Economic Development
Youth in Development
Agriculture
Environment
How did you learn about this program?
OMB Control Number 0420-0540
Expiration Date: X/XX/2014
Privacy Act Notice: This information is being collected pursuant to 22 U.S.C. 2501(a). This information will be used in processing your enrollment in the Correspondence Match program. Disclosure of this information is voluntary. Failure to provide sufficient information may preclude your consideration for Correspondence Match. This information may be used for the routine uses described in the Privacy Act, 5 U.S.C. 552a, and the Peace Corps' published Routine Uses, summarized in Peace Corps' System of Records.
Paperwork Reduction Act Burden Statement: Public reporting burden for this information collection is estimated to average 10 minutes. This includes the time for reviewing instructions and completing the information. This is voluntary information collection. An agency may not conduct or sponsor, and persons are not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: the FOIA Officer, Peace Corps, 1111 20th Street NW, 2nd Floor, Washington, D.C. 20526.
PC-DP.969.5 (Rev. 04/2014)
World Wise Schools Navigation
Expand PeaceCorps.gov Navigation
Main Navigation
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Heys, Karen |
File Modified | 0000-00-00 |
File Created | 2021-01-23 |