iE Local Coordinator (LC) Application First Name * Last Name * Street Address * City * State * Zip Code * Home Phone * Cell Phone * Email Address * Are you authorized to work in the U.S.? * Are you authorized to work in the U.S.? *YesNo Are you at least 25 years of age? * Are you at least 25 years of age? *YesNo Do you have a valid driver’s license and reliable means of transportation? * Do you have a valid driver’s license and reliable means of transportation? *YesNo Do you have regular access to a computer and the internet? * Do you have regular access to a computer and the internet? *YesNo Have you ever worked with teenagers? * Have you ever worked with teenagers? *YesNo If yes, please explain: Have you ever been convicted of a crime other than a misdemeanor traffic violation? * Have you ever been convicted of a crime other than a misdemeanor traffic violation? *YesNo If yes, please explain: What is your highest level of education? * What is your highest level of education? *Less than a high school diplomaHigh school diplomaSome collegeAssociate DegreeBachelor’s DegreeMaster’s DegreePhD Are you currently, or have you previously, worked or hosted for another student exchange organization? * Are you currently, or have you previously, worked or hosted for another student exchange organization? *YesNo If yes, please explain: Please list any volunteer roles you have served in your community * The LC position consists of two major areas of responsibility, please select the areas you are most interested in * The LC position consists of two major areas of responsibility, please select the areas you are most interested in *Recruiting host families and making placementsSupervising students while they are on exchangeBoth LCs can recruit host families and supervise students within 120 miles of their home. How far are you willing to travel? * LCs can recruit host families and supervise students within 120 miles of their home. How far are you willing to travel? *Within my local community onlyUp to 15 milesUp to 30 milesUp to 60 milesUp to 120 miles How did you hear about International Experience? How did you hear about International Experience?FacebookLinkedInInstagramIndeedRelative/FriendCommunity GroupInternet SearchWord of MouthPrinted Material (Flyers, Postcards, Etc.) EMPLOYMENT 1 - Name of current or most recent employer * Dates of employment * Your Title * City * State * Description of your major areas of responsibility * EMPLOYMENT 2 - Name of former employer Dates of employment Your Title City State Description of your major areas of responsibility REFERENCE 1 - Name * (No Relatives) Email * Home Phone * Cell Phone * Relationship * REFERENCE 2 - Name * (No Relatives) Email * Home Phone * Cell Phone * Relationship * REFERENCE 3 - Name * (No Relatives) Email * Home Phone * Cell Phone * Relationship * Submit