<p> www.theglobalintern.com +1.973.537.6800 Accommodation Booking Form</p><p>FORM SUBMISSION</p><p>Please submit to:  Email: [email protected]  Post: Global Internships, LLC 5 Meadow Lark Ct Randolph, NJ 07869</p><p>After receipt of this booking form, Global Internships, LLC will issue an invoice for the accommodation and options you have selected. If you have any questions regarding any of the options please contact us. If you are booking accommodations for a group, please call our office. </p><p>AGREEMENT</p><p>Please sign and date. If you are emailing the application, please scan your signature, or post the agreement page with signature separately. </p><p>I hereby confirm that all the information provided in this application is correct and current. </p><p>Print Full Name Date</p><p>Signature</p><p>Page 1 of 3 2/21/2008 4:47 PM Confidential -Global Internships, LLC www.theglobalintern.com +1.973.537.6800 Accommodation Booking Form</p><p>PERSONAL INFORMATION </p><p>Date: Male Full Name: Date of Birth Female Primary Address: </p><p>Home Telephone: Email: </p><p>Cell Phone: </p><p>Emergency Relationship: Contact:</p><p>Phone: Email: </p><p>School/University: Graduation Year: </p><p>Citizenship: </p><p>Page 2 of 3 2/21/2008 4:47 PM Confidential -Global Internships, LLC www.theglobalintern.com +1.973.537.6800 Accommodation Booking Form</p><p>ACCOMODATION INFORMATION</p><p>Please select the housing type you are interested in:</p><p>Residence Hall– Student dormitory housing (available summer only) Flat/Student House- Apartments with single or double bedroom and shared kitchen/living-room/bathroom and various in- building amenities</p><p>Host Family Host Family choices: Budget- Clean, comfortable accommodation located in zones 4-5 Standard 3- Clean, comfortable accommodation located in zone 3 Standard 2- Clean, comfortable accommodation located in zone 2 Superior- More sophisticated accommodation located in prime areas of zones 2 and 3 (or occasionally, standard level accommodation in zone 1). Executive- More luxurious accommodation, located in zones 1 and 2, close to the city centre with TV in the room, sometimes with private bathroom. Meal Plan Option: Continental Breakfast (BB) Continental Breakfast, Dinner (HB) Use of kitchen only (SC)</p><p>Is a house with kids acceptable? YES NO Is a house with pets acceptable? YES NO Would you like to be placed with a family or roommate YES NO Religion: of the same religion? Are you willing to attend religious gatherings of host YES NO family if different from your own religion? Do you have any health or dietary issues? YES NO Do you smoke? YES NO If you don’t smoke, can you live with others that do YES NO smoke?</p><p>Page 3 of 3 2/21/2008 4:47 PM Confidential -Global Internships, LLC</p>