St. Sebastian's Delegate Application 2018

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“Every journey of a thousand miles begins with….. paperwork?”
So it seems and this journey, alas, is no different...it just involves a little less paper.

Please note the following instructions for completing the delegate application:

Fill out the following form completely. Once finished, the form will be submitted to the SHARE Delegation Coordinator and the US Organizer.

Also be sure to print, sign, and date Liability Waiver (all delegates) and Parent Permission Form (delegates under 18 years of age only) found on the SHARE Delegate Application page. Give these forms, along with a copy of the photo page of your valid passport, to your US Organizer.

Email *

Título sin título

Delegate Information

Name *

Gender *

Female

Male

Address *

Street Address, City, State, Zip Code

Primary Phone Number *

School Email Address *

Personal Email Address *

Date of Birth *

YYYY

Place of Birth *

Citizenship *

Passport Number *

Passport Expiration Date *

YYYY

What is your level of Spanish comprehension/verbal skills? *

Emergency Contact (if under 18, this should be your parent/guardian)

Name *

Relationship to applicant *

Address *

Street Address, City, State, Zip Code

Primary Phone Number *

Additional Phone Numbers

Medical and Health Questionnaire

Do you have any of the following dietary restrictions? *

Vegetarian

Vegan

Lactose Intolerant

None

Other:

Required

Do you have any food allergies? *

If yes, please list...

List all medications you are currently taking *

El Salvador is a poor country. Living conditions during your stay may include: a basic diet of beans, rice and tortillas, a hot and humid climate, rough roads and hiking, and primitive toilet facilities, especially when in the countryside. *

In light of these conditions, please assess your physical condition. Indicate any disabilities, allergies, medical or emotional conditions you have that may affect your ability to participate in group activities.

A typical, moderate delegation experience will include a small amount of physical exertion; ie, walking uphill for 10-15 minutes across uneven terrain in high heat and high humidity. Itineraries can be adjusted to accommodate the physical capabilities of the delegates. Considering these conditions, please mark the statement that best applies to you: *

I DO NOT have the physical capacity to accomplish the level of exertion stated above. Please coordinate alternative activities.

I DO have the physical capacity to accomplish the level of exertion stated above.

I am in good physical condition and would welcome the possibility of participating in activities that may include some physical exertion, such as longer walks and/or hikes in the communities.

Required

Why do you want to participate in a SHARE Delegation in El Salvador? *

On a scale of 1(not at all) to 10(very well) how well do you feel you know the history and current situation in El Salvador? *

Explain your experience/knowledge:

Do you have any special gifts, talents or abilities that you would like to share now, during the trip or later? *

What is your understanding of solidarity and accompaniment? *

How do you deal with being in uncomfortable situations that you have little control over? *

Describe previous experiences you have had confronting injustices and sharp levels of poverty. *

What is your relationship to the group you’re traveling with? How well do you know, or how comfortable do you feel around the other members of the group? *

Thank you for being part of SHARE El Salvador Delegations!

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