"There is no moment of delight in any pilgrimage like the beginning of it."

- Charles Dudley Warner, American Essayist

EnRoute's Official Questionnaire

Thank you for taking the time to fill out EnRoute Consulting's questionnaire. Please be as detailed as possible in answering the following questions, as we will be using this information to begin researching possible opportunities for your time off. These details will help us determine which opportunities might be of particular interest to you. It is important for you to start thinking seriously about where and how to spend your time. In addition to filling out the following questionnaire, please send a current copy of your resume detailing past and current volunteer and work experience.

You can either fill the form out below and submit it online OR print it out and mail it in. Download here: Questionnaire.pdf

Privacy Policy: The information you provide EnRoute is confidential and for our use only. EnRoute will not under any circumstances sell or distribute your information to third parties.

Questionnaire

The Basics  
Full Name:*
Address:
Home Phone:*
Cell Phone:
Email:*
Date of Birth:
Current School & Year:
Parental Information: 
Mother's Name:
Mother's Occupation:
Mother's Email:
Mother's Phone:
Father's Name:
Father's Occupation:
Father's Email:
Father's Phone:
Parent's Marital Status:

If other: 
How did you hear about EnRoute?:
About You  
When would you like to begin your time off?:
How long would you like it to last?:
Can you approximate a range for your budget for your time off,
including money you intend to save or fundraise? :
Where have you traveled within the United States?
Which areas did you enjoy the most? :
Have you traveled outside the United States? If so, where:
What languages have your studied and for how long?:
What are your hobbies?:
What are your favorite subjects in school? :
Do you have any medical conditions that could
physically or mentally impede your experience?
If so, please explain briefly: :
Where in the World?  
Do you have duel citizenship and if so, with what country?:
Are there any languages you are interested in learning or becoming more proficient in?:
Where would you like to explore opportunities?
You may write in your answers or check from the following (The suggestions are meant to get your wheels turning):
United States:  
 Northeast Midwest Southeast Rocky Mountains
 Appalachia Southwest Alaska Hawaii
 Pacific Northwest California
International:  
 Argentina Australia Austria Belgium
 Belize Bolivia Botswana Brazil
 Cambodia Canada Chile China
 Costa Rica Croatia Denmark Ecuador
 Egypt Fiji Finland Frances
 Germany Ghana Greece Iceland
 India Ireland Isreal Italy
 Japan Kenya South Korea Lithuania
 Madagascar Malta Marshall Islands Mexico
 Mongolia Nepal Netherlands New Zealand
 Peru Poland Portugal Russia
 South Africa Spain Sweden Switzerland
 Tanzania Thailand United Kingdom Vietnam
Other Country:
What type of lifestyle setting would you prefer?:
Would you prefer traveling/working with a group of peers or alone?:
Are there specific goals, passions or interests you hope to explore during your time off?:
What subjects would you like your programs/activities to center around?
Feel free to fill in your own ideas at the bottom.
 Visual Art/Museums Technology Environmental Conservation
 Humanitarian Aid Farming/Agriculture Wildlife Conservation
 Adventure Travel Outdoor Activites Teaching
 Sports Anthropology Health/Medicine
 Children Tourism Science
 Politics Cooking/Cuisine World Languages
 Media Martial Arts Spiritual
Creating Art:  
 Ceramics Photography Painting
 Film Creative Writing Theater
 Drawing Sculpture
Other Subjects:
How many different experiences or programs are you interested in participating in during your gap year? :
Imagine a year from now you are looking back on your experience.
What do you hope to have achieved during your time off?:

*Required fields