East Carolina University - Language Exchange Form

Name:

Address:

E-mail Address:

Age:

Gender:

Phone Number:

Language(s) you’re learning:

Please select the current level of the language you would like to practice. :

No knowledge

Basic Level

Intermediate Level

Advanced Level

Native Language(s):

ECU Banner ID number:

Home country:

Major:

Minor:

Hobbies/interest(s):

Best time to meet with Partner:

Any other comments/requests:

Acknowledgment:

Yes

No

I acknowledge that my electronic signature on this form indicates my consent and approval for the ECU Office of International Affairs to distribute my personal information to another individual solely for the purpose of matching me with another ECU Language Exchange partner. I acknowledge that this information may be shared with ECU students, staff, and/or those in the wider Greenville community in order to find a suitable language exchange match. I further acknowledge and agree that my participation in this language exchange program is voluntary, and I agree not to hold ECU or its Office of International Affairs responsible for any complications related to the language partner exchange, including but not limited to scheduling, and/or the failure to find an adequate language match for my partner or skill level.

Signature:

Date: