<p>Park Street Church, Boston USA Form Revision Date 5/10/2018</p><p>For Official Use ONLY T/Th</p><p>N</p><p>F</p><p>R</p><p>Level</p><p>Last</p><p>Pd</p><p>Wtg</p><p>FRIENDSHIP MINISTRY TO INTERNATIONAL STUDENTS & SCHOLARS</p><p>Professional Communications Workshop Registration Form</p><p>INSTRUCTIONS: (1) Fill in GREY sections. Fill in dates as MM/DDYYYY (Ex: July 4, 1960 = 7/4/1960). Complete all items marked (*). (2) Save form and email to [email protected]. (3) Digital copies of your resumé and paper (or report) are due prior to first class.</p><p>ABOUT YOURSELF</p><p>FAMILY NAME * FIRST NAME *</p><p>GENDER * MALE FEMALE BIRTH DATE (Please tick one.) MM/DD/YYYY Click here to enter a date.</p><p>RELIGION ARE YOU MARRIED? * YES NO (Please tick one.)</p><p>HOME COUNTRY *</p><p>HOME COUNTRY ADDRESS (For temporary visa holders only.)</p><p>VISA TYPE * ARRIVED IN BOSTON ON * ex: J1, F2, B, H1b MM/DD/YYYY Click here to enter a date.</p><p>LEAVING BOSTON ON MM/DD/YYYY Click here to enter a date.</p><p>U.S. ADDRESS * Street Name </p><p>Apartment Number City Postal Zip Code</p><p>U.S. PHONE NUMBER * EMAIL ADDRESS *</p><p>EMPLOYER or SCHOOL * (Please fill in the name of University or Research Hospital or Company in the U.S.)</p><p>DEPARTMENT</p><p>DEGREE PROGRAM (If you are studying or working in a university or a research hospital, please fill in for example - B.A., M.A., Ph.D., post-doctoral, visiting scholar, etc.) ABOUT YOUR SPOUSE (Please leave this section empty if you are not married.)</p><p>FAMILY NAME * FIRST NAME *</p><p>EMPLOYER or SCHOOL * (Please fill in the name of University or Research Hospital or Company in the U.S.)</p><p>DEPARTMENT</p><p>DEGREE PROGRAM (If you are studying or working in a university or a research hospital, please fill in for example - B.A., M.A., Ph.D., post-doctoral, visiting scholar, etc.)</p><p>ABOUT YOUR FAMILY (Please leave this section empty if you do not have children.)</p><p>CHILD #1 FAMILY NAME *</p><p>GENDER * (Please tick one.)</p><p>GENDER * (Please tick one.)</p><p>CHILD #2 FAMILY NAME *</p><p>CHILD #4 FAMILY NAME *</p><p>CHILD #3 FAMILY NAME *</p><p>GENDER * (Please tick one.)</p><p>GENDER * (Please tick one.)</p>