Canadian Foodgrains Bank

Food Study Tour Application Form

Kenya/Rwanda 2012

This tour is open to Canadian adults who are interested in learning more

about international hunger and food security and have an interest in sharing that learning with

others. Foodgrains Bank supporters are especially encouraged to apply.

Full Name
Field of Work or Study
Date of Birth
Church or Church Affiliation
Address - Street/Box #
Town/ City/
Postal Code
Telephone / Fax
Email
Emergency Contacts –
Name / Phone / Email / 1)
2)
Personal References -
e.g. (Pastor, teacher, employer, etc.)
Name / Phone / Email / 1)
2)
3)

Long answer questions (click in the text box, boxes expand as you type):

  1. Do you have previous awareness of or involvement with Canadian Foodgrains Bank? If yes, please describe. (i.e. volunteer, donor, past study tours, etc)
  1. How did you hear about this opportunity?
  1. Why you are interested in a Food Study Tour?

Food Study Tour Application – Canadian Foodgrains Bank

This form may be printed and mailed or submitted via email.Page 1

  1. What do you hope to learn as a Food Study Tour participant?
  1. Participants are required (in keeping with your own skills and gifts) to share their learning with others in your church, community, and region and the general Canadian Foodgrains Bank constituency. They are also expected to support to relevant campaigns or initiatives on behalf of Canadian Foodgrains Bank after returning to Canada. Please indicate your willingness to do this in the box below and briefly describe how you see yourself accomplishing this.
  1. Describe, if any, your previous international travel experience.
  1. Do you have any physical, emotional, educational or dietary needs that require accommodation? If yes, please describe them in detail.

6. Would you require financial assistance? ___ YES ___ NO

6. Food study tour participants will be expected to follow mutually agreed upon guidelines for meaningful cross-cultural interaction and ethical travel (ie. photography, gifts, etc). Please indicate your willingness to:

Abide by guidelines on cross-cultural appropriateness. ___YES ___NO

Participate in group learning, debriefing, or reflection. ___YES ___NO

Engage in respectful and relevant dialogue with others. ___YES ___NO

Be adaptable/flexible if confronted by unexpected changes. ___YES ___NO

In order to obtain in-country travel visas, we require the following information:

Nationality______

Date of Birth Place of Birth ______

Passport information (not necessary for application, but will be required for tour)

#______Place of Issue ______

Date of Issue Date of Expiry ______

Thank you for your interest in Food Study Tours. Please return this application to Canadian Foodgrains Bank as soon as possible. We will contact you within 4 weeks of receipt of your application. If you have any additional questions, please don’t hesitate to give us a call.

Canadian Foodgrains Bank

Box 767, 400 – 393 Portage Ave

Winnipeg, MB R3C 2L4

1-800-665-0377

1-204-944-1993

FAX: 1-204-943-2597

Attn:Public Engagement Coordinator

or email to

Food Study Tour Application – Canadian Foodgrains Bank

This form may be printed and mailed or submitted via email.Page 1