IOU Respect
International Exchange Application
Summer 2014, Tunisia
Egypt, France, Germany, Lebanon, Tunisia, United States
Complete and email application to:
Application deadline: June 15, 2014
(1) Personal Information
First and last name:
Date of birth:
Country you are from:
Preferred mailing address
address 1
address 2
City ST Zip
Email:
Phone: home (Work) work (Cell) mobile
Age: age
Sex: M F
Occupation:
English is the official language of the IOU Respect program. Please check your ability level.
Ability: beginner intermediate advanced extremely advanced fluent
Are you a vegetarian? Yes No
Other dietary needs:
Are you allergic to anything? Yes No
If yes, explain:
(2) Motivation to participate
Answer each of the questions in this section in typed paragraphs. Do not exceed 200 words for each question. Attach answers to this application.
1. What do you hope to learn through interaction with youth from Egypt, France, Germany, Lebanon, Tunisia, and the United States?
2. Describe a class you have taken, a book you have read, or an encounter that you have had that has inspired you.
3. What experiences have you had interacting with people of ethnic, racial, or socio-economic backgrounds that differ from your own?
4. To facilitate learning and building bridges between cultures, participants will engage in up to 20 hours (5 sessions) of dialogue sessions throughout the two-week program. Are you willing to engage in all of these sessions and listen to the experiences and ideas of other participants as well as share your personal experiences with others? By checking “Yes” you are committing to participate in all dialogue sessions: Yes No
(3) Hostelling Experiences
Have you ever stayed at a youth hostel before? Yes No
If yes, describe a positive experience you had while staying at a hostel. If no, describe what you think you can gain from staying at a hostel versus a hotel.
Do you currently have a Hostelling International membership? Yes No
(4) Work/Volunteer Experience
Please describe any involvement in work activities, volunteer experience, or organizations that you have been a part of that will help you with skills necessary to communicate effectively with those of different cultures from your own. Please limit your answer to 200 words. Attach additional page if necessary.
What are your career goals?
(5) Interests/Skills
What are your favorite leisure time activities?
Do you have any special skills that you might be willing to share during the international exchange? Artistic skills? Photography? Musical skills? Writing? Video production? Web site development? Etc.
(6) Education
Level of education: currently in college college graduate graduate student
College or University name:
Degree earned or current major area of study:
Describe experiences you have had in school or work settings working with groups of people. What insights about yourself or group dynamics did you learn?
(7) Travel Experience
Where have you travelled and for what purpose?
Describe what you think is the most important thing you can learn through travel and how one might go about learning this.
(8) Additional information
Do you have a valid, current passport? Yes No
Note: Any person chosen as a participant for this program will need to provide a photocopy of his/her passport by July 20, 2014.
Have you ever been convicted of a crime (other than a traffic violation?) Yes No
If yes, please explain.
Reference
Please send a reference form to a current or former supervisor, group leader, or teacher and provide this person's name, complete address, email address, and relationship to you below. Your reference must complete and submit the online reference form by June 15, 2014.
Reference Name:
Relationship to you:
Address:
Phone number:
Email address:
Although this application places no obligation either on you or on Hostelling International, it does indicate a serious intention on your part to join the IOU Respect international exchange program. Should you decide to withdraw your application, please notify us immediately.
If completing electronically, please enter your initials in the area below.