TliE CISV VILLAGE PROGRAM - CISV Springfield

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What are your activities outside of school? ________________________________________________________________ ________________________________________________________________ What is your CISV background? ________________________________________________________________________ ________________________________________________________________________ How did you learn about CISV? _______________________________________________________________________________ _______________________________________________________________________________ Parent or Guardian Information Mother’s/Guardian’s Name ____________________________________________________________________________ Occupation ____________________________________ Business Name and Address __________________________________________________________________________ City_____________________________________________State__________________Zipcode_______ Business Phone: _____________________Fax: __________________ E-mail address: __________________ Home Address and Phone: ___________________________________________________________________________ (If different from that of youth applicant) Father’s/Guardian’s Name ____________________________________________________________________________ Occupation ____________________________________ Business Name and Address
__________________________________________________________________________ City_______________________________________State____________________Zipcode___________ Business Phone: ___________________________________Fax: __________________ E-mail address: __________________ Home Address and Phone: ____________________________________________________________________________ (If different from that of youth applicant) Statement of Parents/Guardians Why do you want your child to be a delegate? Mother’s response: __________________________________________________________________________________ Father’s response: __________________________________________________________________________________ In what volunteer activities do you participate? Mother’s response: __________________________________________________________________________________ Father’s response: __________________________________________________________________________________ Would you be able and willing to assist in volunteer service for CISV? Please explain. Mother’s response: __________________________________________________________________________________ Father’s response: __________________________________________________________________________________
Page 1 and 2: CHILDREN’S INTERNATIONAL SUMMER V
Page 3: Parents: Electronic Communication/P
Page 7 and 8: Youth Delegate Application Form - p
Page 9 and 10: Movie and TV Favorites: I watch ___
Page 11 and 12: Teachers Information Package - Vill
Page 13 and 14: Youth Delegate Reference Form Child
Page 15: CHILDREN’S INTERNATIONAL SUMMER V

TliE CISV VILLAGE PROGRAM - CISV Springfield

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