Staff-Leader Application Form Staff-Leader Application Form Step 1 of 7 14% Staff-Leader Application FormTo be filled in by all persons applying for a position of responsibility (including staff, leaders, JCs, junior staff, junior leaders) in a CISV international programme and sent to the person responsible for staff/leader selection in the applicant’s home NA. For international staff positions, this form must be signed first by the person in the applicant’s home NA who is responsible for staff/leader selection and then forwarded by that person to the responsible member of the Host NA.Program(s) you are applying forPlease make sure if you are applying for multiple camps/positions that their row entries match. Program 1 Position 1 Year 1 Reference Number 1Program(s)(Required)Use the plus button to add another Entry Add RemovePosition(Required)Use the plus button to add another Entry Add RemoveYear(Required)Use the plus button to add another Entry Add RemoveProgram Reference Number(Required)Use the plus button to add another Entry Add Remove Personal InformationYour Name(Required) First Last 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 number for you to be reached at?Email(Required) Date of Birth(Required) MM slash DD slash YYYY Gender Identity Ocupation(Required)Employer(Required)Or Academic Institution if a studentEducational Background(Required)Degree and year (if applicable)PLease note any health restrictions and their effects on your daily life.Language(Required)Fluency(Required)FluentGoodFairLanguageFluencyFluentGoodFairLanguageFluencyFluentGoodFairLanguageFluencyFluentGoodFair In the CISV programme, you will need to assist and or assume responsibility for some activities such as music, arts and crafts, games, sports, dance, discussion and swimming etc. Please list your interests and skills, which could be helpful at the programme:Do you have certifications? Yes No Please describe any first aid or other life saving certifications you have.Be sure to include issue and expiration dates if applicable. Experiences in working with people in leadersip roles and as part of a teamCISV or other experiences with children/youth (of similar age to the specific programme participants)Other experiences in CISV, with other intercultural organizations or with other culturesWhy do you want to be staff/leader/JC? References(Two references are required. Please give the official CISV Reference Form to your references listed below and ask them to forward the completed forms directly to the person responsible for staff/leader selection in your NA.)References 1Name First Last Address 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 PhoneEmail References 2Name First Last Address 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 PhoneEmail Explanation for staff-leader applicationPlease see the relevant Programme Guide and CISV International policies on selection of persons with programme responsibility Info File R-05 Guidelines on Discrimination, Selection & Behaviour. Data The personal data provided in this form is confidential and will be kept and eventually destroyed according to the laws of the country holding the data. Staff, leaders and JCs must be members of their local CISV Chapter or National Association or join once they are selected, prior to the programme. Age Requirements Staff must be the proper age on the first day of the programme. Leaders and JCs must be the proper age on the day of departure for the programme. Specifically: ● Junior Counsellors must be 16 or 17 years old ● Interchange junior leaders must be at least 23 years old and it is recommended that there be at least four years between the participant age and the age of the junior leader ● All adult leaders and staff must be at least 21 years old ● At least one member of the staff of every Village, Step Up, Youth Meeting, and Seminar Camp must be at least 25 years old ● In Step Up, Village and Youth Meeting, where there are 4 or more adult staff members, there may be 1 junior staff from the hosting NA. Junior staff in a Village must be at least 19 years old. ● All staff and leaders must receive appropriate orientation and leadership training as specified in CISV International policies and guides Police checks Unless local law forbids it, police checks are required for all staff/leaders (aged 18+) at all CISV International programme and activities. International programme staff Please remember to follow the proper procedure and start the process very early as it will take some time to go through each of the steps. For NAs hosting IPP, Seminar Camp, Step Up, Village or Youth Meeting ● In every case, the person responsible for staff selection in the host NA should send a formal inquiry to the home NA of the person they want to invite, asking if they may invite him/her. The home NA might refuse if they feel that they cannot recommend the person as a staff, or that they need the person for a programme at home. If this is the case, the home NA has the final say. ● If the home NA agrees, the person in the host NA responsible for staff selection should send an invitation to the invited person with a copy to the home NA. The invitation must contain the Staff-Leader Application Form, two Reference Forms, as well as a clear statement regarding the following: - the position (Programme Director or ordinary staff member) - any financial obligations, travelling conditions, etc. - relevant staff education/training - pre- and post- programme days For all international staff An applicant for an international staff position for any programme must: ● fill in a Staff-Leader Application Form and send it to the person in their NA who is responsible for staff selection ● ask two referees to complete the official CISV Reference Forms and forward them directly to the person in their NA who is responsible for staff selection ● work with the person in his/her home NA who is responsible for staff selection to arrange for a police check (where possible according to national law) to be carried out and sent to that person for review The person in the Applicant’s home NA who is responsible for staff selection should: ● review the Staff-Leader Application Form, references and police check ● (if all is satisfactory and the applicant is considered to be a suitable candidate) sign the CISV certification at point 11 of the Staff-Leader Application Form ● forward a copy of the Staff-Leader Application Form and the references (not the police check) to the person in the host NA who is responsible for staff selection, which indicates that the home NA is agreeing that the person may be selected for an international staff position Anyone interested in becoming international staff can check for international programme staff opportunities on www.cisv.org. CISV I have read and understand the National Travel PolicyApplicant Signature(Required)
