If you are interested in learning more about the local coordinator position, please complete and submit the application below.IE Local Coordinator (LC) Application LC_Application LC Application First Name:* Middle Initial: Last Name:* Street Address:* City:* State:* Zip:* Home Phone:* Cell Phone:* Email:* Are you authorized to work in the U.S.?* Yes No Are you at least 25 years of age?* Yes No Do you have a reliable means of transportation and a valid driver’s license?* Yes No Do you have regular access to a computer and the internet?* Yes No Have you had any contact with any Child Protection Agencies in the Past?* Yes No If yes, please explain: Have you ever been convicted of any crimes other than traffic violations, including sex-related or child abuse offenses?* Yes No If yes, please explain: What is your highest level of education?* Less than a high school diploma High school diploma Some college Associate Degree Bachelor’s Degree Master’s Degree PhD Are you currently, or have you previously, worked or hosted for another student exchange organization?* Yes No If yes, please list: Please list any volunteer roles you have served in your community* The LC position can consist of two major areas of responsibility: 1. Recruiting host families and making placements, and 2. Supervising students while they are on exchange in the U.S. What are you most interested in?* Recruiting host families and making placements Supervising students while they are on exchange Both LCs are able to recruit host families and supervise students within 120 miles of their home. How far are you willing to travel to recruit a host family and/or supervise a student?* Within my local community only Up to 15 miles Up to 30 miles Up to 60 miles Up to 120 miles How did you hear about International Experience?* EMPLOYMENT - Current Employer Name of Company/Organization: City and State: Your title: Description of your major areas of responsibility: EMPLOYMENT - Former Employer Name of Company/Organization: City and State: Your title: Description of your major areas of responsibility: REFERENCES: Please list three references who are NOT related to you. At least two professional references must be your current or previous direct supervisor or manager. 1 REFERENCE 1 Name:* Email:* Home Phone:* Cell Phone:* Relationship:* REFERENCE 2 Name:* Email:* Home Phone:* Cell Phone:* Relationship:* REFERENCE 3 Name:* Email:* Home Phone:* Cell Phone:* Relationship:* Don't fill this field!