Fortnight Application & Supplement FORTNIGHT APPLICATION FORM Application form for youth delegates interested in Fortnight Step 1 of 8 12% Fortnight Delegate ApplicationUse this application if applying for Fortnight.Your Name(Required) First Last Gender Identity(Required)What gender do you identify asBirth Date(Required)What Month, day, year were you born MM slash DD slash YYYY Racial Identity/Ethnicity(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone(Required)What is the best phone number to contact you atYour Email Address(Required)What is the best email address to contact you at Enter Email Confirm Email School(Required)Which school do you attend Grade(Required)What is your current gradePrincipal's Name(Required) Help us get to know you a little betterWhat are your interests and hobbies?(Required)What are your activities outside of school?(Required)How did you learn about CISV?(Required)What is your CISV Background?(Required) CISV requires that both custodial parents/guardians sign this application form, thus confirming that the applicant has permission from both custodial parents/guardians to travel. If an applicant is selected, all additional required CISV forms can be signed by just one custodial parent/guardian, unless CISV is informed in advance of custody issues that make necessary the signatures of both.Check the option that best describes your situation(Required)Please select the option that best describes your situation. *Documentation of full legal custody must be provided Parents/Guardians are maried Parents/Guradians are divorced and share custody Parents/Guradians are divorced and one has full legal custody Parents/Guardians are not maried but share legal custody Parents/Guradians are not maried and one parent has full legal custody Non-parent legal guardian has full legal custody Other Name of parent/guardian with legal custody(Required)Please Specify(Required)Please give some details about your specific situation. Parent/Guardian 1 InformationYour Name(Required) First Last Address(Required)(If different from applicant) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Occupation(Required)Employer(Required)Office PhoneIf you have onePhone(Required)What is the best phone number to contact you atYour Email Address(Required)What is the best email address to contact you at Enter Email Confirm Email Why do you want your child to participate in CISV?(Required)If you are currently a member of CISV, please list the volunteer activities you take part in with your chapter:(Required)CISV is a global organization run primarily by volunteers. If your child is selected, in what areas of the organization are you interested in volunteering? Parent/Guardian 2 InformationYour Name First Last Address(If different from applicant) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands OccupationEmployerOffice PhoneIf you have onePhoneWhat is the best phone number to contact you atYour Email AddressWhat is the best email address to contact you at Enter Email Confirm Email Why do you want your child to participate in CISV?If you are currently a member of CISV, please list the volunteer activities you take part in with your chapter:CISV is a global organization run primarily by volunteers. If your child is selected, in what areas of the organization are you interested in volunteering? Child's Medical HistoryList any allergies, health, or dietary restrictions and their effect on your child's daily activities.(Required)If your child is selected, a physician’s declaration of your child’s health and fitness for CISV participation will be required. National Code of Conduct Agreement(Required)I do agree with my local CISV Chapter and the National and International officers of CISV to participate fully in the CISV Program previously selected – Fortnight. I will abide by the guidelines established by CISV International, INFO FILE R-7 (9008), in such a manner that will enhance our life together and foster courtesy and understanding between us all. I will not bring or use illegal drugs. I will not drink or smoke, even if I am of legal age in the country I am visiting. I will observe such sexual mores and behaviors that will not embarrass or injure others (such behaviors having been discussed with my parents/guardians). I understand I will be expected to participate in all CISV activities (games, culture sharing, crafts, singing, dances, meetings and workshops, etc.) and I agree to participate to the best of my ability. I further agree to represent my CISV Chapter in a manner that is consistent with the values of my home, community and country. I understand that if I break my agreement, I may be removed from the program at my own expense. I have read and understand the National Code of Conduct Agreement.National Travel Policy(Required)1) Village, Step Up, and Youth Meeting delegations shall travel to and from the site of the approved CISV activity as a group. Travel shall be direct and continuous to and from the CISV activity site. No side trips shall be permitted. No layover in excess of 24 hours shall be permitted unless common carrier schedules require otherwise. Delegation itineraries must be approved by the local Chapter. 2) Penalties - Violations of Section 1 will result in disciplinary action against the Chapter or Steering Committee pursuant to the complaint procedure (83-BOT-2) of CISV, Inc. 3) Individual travel (as in the case of Junior Counselors, Fortnight and Seminar Camp) other than to and from the site of an approved CISV activity shall be deemed non-CISV travel. CISV assumes no responsibility or liability for an individual while on a side trip or layover in excess of 24 hours. I have read and understand the National Travel PolicyIN SIGNING THIS APPLICATION, WE (APPLICANT AND PARENTS/GUARDIANS) CONFIRM THAT:(Required)-We have read, understand, and agree to abide by the CISV USA Travel Policy. -We acknowledge that we will have to review and sign the National Code of Conduct upon selection -The information we have provided in this application may be verified by contacting individuals and agencies other than those listed in this application. -We release and hold harmless any individual or organization that provides additional information about us to CISV. We also hold harmless any officers or volunteers of CISV International, CISV USA, or the local Chapter of CISV. All information provided on this application is true and correct.Applicant Signature(Required)Parent/Guradian 1 Signature(Required)Parent/Guradian 2 Signature Fortnight Supplemental ApplicationFortnight is a two-week program that focuses on strengthening leadership skills within CISV. It is a domestic program that allows more 16–17-year-olds to participate from all the chapters in CISV USA. Please answer the following questions.Why are you applying for Fortnight and what you strive to get out of the program?(Required)Please share 1-2 of your strengths in leadership opportunities you have had along with 1-2 challenges you have run into.(Required)Upon returning from the Fortnight Program, how do you plan to be involved on the local level? How will you use your Fortnight experience to benefit your Chapter?(Required)Please read and complete the next part of this application.Applicant's Signature(Required)I am submitting my application for participation in a CISV Fortnight Camp. I have read, understand, and agree to: -Respect the decisions of the Fortnight Chair and committee. -Respect the CISV requirements on Behavior and Cultural Sensitivity, as outlined in Info File R-07 the Positive Behavior Policy; Info File R-07 -Participate in all Fortnight participant preparation offered. -Participate in local Junior Branch (JB) activities before and after my Fortnight Camp experience. Parent/Guardian 1 Signature(Required)I/We am/are aware of and fully support my child/our child’s application for participation in a CISV Fortnight Camp. I/We have read, understood, and agree to: -Respect the decisions of the Fortnight and committee. -Ensure that our child participates in all Fortnight Camp participant preparation. -Encourage our child to participate in local Junior Branch (JB) activities before and after his/her program. -Assist our child with Fortnight preparations, including (but not limited to) health, legal, travel, and forms. Parent/Guardian 2 SignatureI/We am/are aware of and fully support my child/our child’s application for participation in a CISV Fortnight Camp. I/We have read, understood, and agree to: -Respect the decisions of the Fortnight and committee. -Ensure that our child participates in all Fortnight Camp participant preparation. -Encourage our child to participate in local Junior Branch (JB) activities before and after his/her program. -Assist our child with Fortnight preparations, including (but not limited to) health, legal, travel, and forms.
