This form is to be used by people living in a country that was once part of the Soviet Union (including countries that were involuntarily forced into the USSR: Estonia, Latvia, Lithuania) ONLY.
This form is to be used by people living in the following countries only: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan.
If you do not live in one of the above 15 countries, click
the "Back" button on your browser to return to the previous page and make
another choice regarding your country of residence.
Print this page, complete the information, and send it to:
SAPE, P.O. Box 319, Monroe, CT 06468-0319, USA
IF YOU ARE UNDER THE AGE OF 18, YOU MUST HAVE YOUR PARENT OR LEGAL GUARDIAN'S PERMISSION TO APPLY FOR A PENPAL AND TO PARTICIPATE IN THE SAPE PROGRAM. APPLICATIONS FROM CHILDREN UNDER THE AGE OF 18 THAT ARE RECEIVED WITHOUT A PARENT'S SIGNATURE WILL NOT BE PROCESSED.
TEACHERS: IF YOU HAVE A CLASS OF STUDENTS WHO WANT PEN PALS, EACH STUDENT MUST COMPLETE A FORM. EACH OF YOUR STUDENTS WILL RECEIVE THE NAME AND ADDRESS OF A PEN PAL, BUT WE MUST ALSO BE ABLE TO PROVIDE THE PEN PAL IN THE OTHER COUNTRY WITH THE NAME AND ADDRESS OF HIS OR HER NEW PENPAL (YOUR STUDENT).
When completing the form, please translate the names of streets or cities by sound only (Example: "Ulitsa Severny"). Do not write the English word for the name (Example: "North Street").
| Name & Surname: | _____________________________________________ |
| Address: | _____________________________________________ |
| City: | _____________________________________________ |
| Post Code: | _____________________________________________ |
| Oblast/Rajon/Region: | _____________________________________________ |
| Country: | _____________________________________________ |
| If you have your own personal email address, write it here: |
_____________________________________________ |
| Are you Male (Boy) or Female (Girl)? |
_____________________________________________ |
| Your Age: | _____________________________________________ |
| Languages You Know: | _____________________________________________ |
| In the spaces below, write
NUMBERS to tell us how many of each kind of penfriend you want.
__________ Male (how many?) __________ Female (how many?) __________ No Preference (how many?) |
|
| Put an "X" in one of the
boxes below to tell us where you want penfriends:
__________ USA Only __________ One penfriend from the USA and the others from anywhere __________ Any Country |
|
| STATEMENT OF TRUTH AND INTENT: By signing
my name below, I declare that all information given on this questionnaire
is true and accurate. I also guarantee that I am the person who will be
corresponding with all penpals requested by me on this form. I promise that
none of the penpal addresses or information provided to me by SAPE will be
redistributed or resold by me and none of the penpal addresses or information
provided to me by SAPE will be posted on the internet for any reason whatsoever.
(Sign your name and write today's date in the space below.)
Signature: _________________________________________________________ Date: ________________ |
|
| IF YOU ARE UNDER THE AGE OF 18, YOU MUST
HAVE YOUR PARENT OR LEGAL GUARDIAN'S PERMISSION TO APPLY FOR A PENPAL AND
TO PARTICIPATE IN THE SAPE PROGRAM. APPLICATIONS FROM CHILDREN UNDER
THE AGE OF 18 THAT ARE RECEIVED WITHOUT A PARENT'S SIGNATURE WILL NOT BE
PROCESSED.
I certify that I am the parent or legal guardian of the above applicant and he/she has my permission to apply for a penpal and to participate in the SAPE Program. Parent's Signature: _____________________________________________________ Date: ________________ |
|
If you are unable to print this form, just write the same information on a blank piece of paper and mail it to us at the address at the top of this page. If you are copying this application by hand, you must copy the words of the above statement IN ITS ENTIRETY and sign your name underneath. |
|
DO NOT EMAIL THIS FORM OR YOUR INFORMATION. WE DO NOT ACCEPT APPLICATIONS OVER THE INTERNET ! ! !