Interest Form | PCC Education Corporation

PCC 2026 Cultural Exchange Interest Form

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Address

Past participants of PCC Program?

Yes

No

Are you applying as an individual or part of a group?

Individual

Group (please specify the group name or organization)

Other

Which program do you want to join ?

March 2026 Program

May 2026 Program

July 2026 Program

Flexible / Not sure yet

Do you have any previous experience with cultural exchange programs?

Why are you interested in this program?

Do you have any talents or skills you would like to share during the program?

(e.g., singing, dancing, playing an instrument, painting, public speaking, sports, etc.)

Would you consider apply a scholarship?

Yes

No

Would you like to receive updates about the program via email?

Yes

No

Video Intro about Yourself (Optional - within 1 min)

Parent Info (if you are still a student, please fill out this part)

Parent Name

Email

Phone