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EFTA01221250

DOJ Epstein Files
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Application Rwanda Project USVI 2009 Applicant name Address: Home phon Cell phone: Email addre Date of bin Name of parents or guardians: &l ei ren ce &rMb erten Parent/guardian phone home phone: Cell phone: Email address School: Grade: ) a O1 Major area of scholastic interest: Club or school o anization membershi Community service wor Application Attachments EFTA01221250 Parent/Guardian Consent Form Clarence, O41-1113trksan for tnarne of applicant); to participate in Rwanda Project 2009. parent/guardian do hereby give my consent to apply I understand that by consenting, I agree that should the applicant named above be chosen, he/she will travel to Rwanda in July/August 2009 for about 15 days, with a group of 16 young people accompanied by four adult chaperones. * Sign * This is not the final consent form, but is required to determine that the applicant has permission to pursue involvement in this project and that you understand the nature of the project. EFTA01221251 EFTA01221252 I — 300 - 500 word essay: "Why I want to go to Rwanda to do Community Service work" 2 — Parent/Guardian permission slip 3 — Two letters of reference (teacher, pastor, principal, advisor, neighbor, community leader) 4 — Financial information form 300 - 500 word essay: Why I want to go to Rwanda to do Community Service work" EFTA01221253