Name *
First
Last
Address *
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Phone *
International format starting with country code (just 001 for the USA). This must be a valid phone number because WE WILL call you if you fit into Jim's schedule. We want to get to know you in order to determine the most suitable travel buddies for Jim.
Email *
Travel Destination *
Departure Date *
/
MM
/
DD
YYYY
Return Date *
/
MM
/
DD
YYYY
Traveling With *
Alone
Friend/s
Parent/s
Spouse
Family
Group
Which languages do you speak well enough to communicate efficiently? *
How well do you write in English? *
Excellent
Good
Fair
Poor
Please answer this question as accurately as you can.
How would you describe your ability to use a digital still camera? *
Excellent
Good
Fair
Poor
How would you describe your ability to use a digital video camera? *
Excellent
Good
Fair
Poor
Will you have any difficulties burning the journal entry, still pictures and video footage you create onto a CD or DVD? *
Yes
No
Not Sure
If you have ANY professional experience as a writer or photographer/videographer, please tell us a little about it.
Please also provide, if possible, a website where examples of your work can be seen/read.
Contact info en route
A phone number and/or email address where you can be reached while traveling would be very helpful!
Why should you be chosen to travel with Jim Monkey? *
What qualities make you ideally suited to travel with Jim? He's really adventurous, wants to learn about different cultures, wants to see the sights and meet new friends. That's what Jim is all about!
Are you currently under exclusive contract with anyone to provide professional writing, photography or videography services which would prohibit you from entering this contractual obligation with Online Trading Company, LLC? *
Yes
No
I have read and understand How to travel with Jim , and will do what is expected of me while traveling with Jim Monkey. *
I agree
I have read, understand and hereby agree with the JimMonkey.com Terms of Use . *
I agree