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TWI For the Children, Inc
Camp2Kids 2010
5929 Queenston Street
Springfield, VA 22152
703-569-9213
twi4kids@earthlink.net
www.twi4kids.org |
APPLICATION
QUESTIONNAIRE
PLEASE RETURN BY
LETTER OR EMAIL
Deadline: March 23,
2011
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Name:
________________________________________________Date:___________________________ |
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Address:
________________________________________________________________________________________
________________________________________________________________________________________
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E-mail:
____________________________________ Telephone:_______________
Fax:____________ |
Guidelines for Camp2Kids
applications:
Age:
No team member will be younger than 18 years. Applicant will have completed
high school.
Guidelines:
I agree to provide a positive leadership example at all times on the
trip. This includes, but is not limited to: no public display of
affection; no inappropriate drinking of alcoholic beverages; and no
inappropriate dress.
I
agree to assist in team activities such as fund raising, obtaining gifts
and sports equipment for schools to be visited; packing for the trip;
and carrying two equipment bags to Bosnia.
Check the activities in
which you would like to be a group leader.
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q 1. Arts/Crafts:
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q 2. Sports/Games:
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q 3. Dancing/Music:
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q 4. Home Team Member: (I
cannot go, but I want to help in preparing for the camp).
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Please provide information on the following questions. |
1. Sex: ____. Age: ____ Weight: ____ Height: _____ List any Health
Problems. List medications:
_______________________________________________________________________________________
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2. Passport Number and date of expiration: (Please provide a photo
copy of the passport 1st page-with picture.)
___________________________________________________________ Expires:
____________________
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3. Can you play a musical instrument or have experience leading
singing or dancing? ( Circle
skills that apply)
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4. Have you traveled abroad? Yes: _____; Which Countries:
___________________.
5. CPR Certified: Yes:___; Life Guard Qualified: Yes:
____; Swimmer: Yes: _____
6. Have you experience with disabled or traumatized children? Yes
_____; No: _____
7. College Student? Yes: ____ No: ____ Graduate
Student? Yes: ____ No: ____
The trip cost (approximately $2,200.00) includes: airfare,
accommodations and transportation in Bosnia. Your personal
costs (optional cultural events, meals) will be approximately $300.00. |
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Please provide a paragraph explaining: |
· Your key strengths
and leadership experiences.
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· The objectives you
wish to gain from the summer camp experience.
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· Why you will be a
valuable team member and a positive example for the children in Bosnia?
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