Study Abroad Contact and Testimonial Form • Ceiba Foundation

Contact Info, Image Use, and Testimonial

Can Ceiba release your name and email address to potential students so they can contact former participants?

Yes

Name

Preferred Email

Can Ceiba use photos and videos from the program that contain your image in newsletters, promotional materials, and/or our website?

Yes

Signature

First Last

Date

Please take a moment to write a one-sentence testimonial about your experiences on the program, that Ceiba can use for course promotion.

This field is for validation purposes and should be left unchanged.