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(1)
Personal Information
Yes
Yes
No
No
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, Morocco, 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.
Yes
No
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.
(5) Interests/Skills
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 College or University name: Degree earned or current major area of study:
graduate student
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?
Describe what you think is the most important thing you can learn through travel and how one might go about learning this.
Do you have a valid, current passport? Yes No Any person chosen as a participant for this program will need to provide a photocopy of his/her passport by June 15, 2012. Have you ever been convicted of a crime (other than a traffic violation?) Yes No If yes, please explain. Please list the two people to whom you have sent reference forms, including their complete address, phone number, email address, and relationship to you. We ask that at least one reference come from a current/former supervisor or teacher. Please do not include relatives or friends. We must receive these references by April 30th. Reference #1 Name: Relationship to you: Address: Phone number: Email address: Reference #2 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.
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