PTE Facilitator Application Form

Facilitator Application Form
Connecting, Involving, Empowering
Welcome to the Peace Train Europe project! A new and innovative way to connect,
involve and empower youth in the local realities through diverse hands-on projects
whilst travelling through and experiencing the various cities that make up Europe!
*Please read the entire form and the Peace Train Guide first before filling it out. You may contact us for further
information if anything is unclear or missing from the form at peacetraineu@gmail.com
• Values Required:
- Open-mindedness
- Flexibility and adaptability
- Readiness to act and react
- Mental and physical endurance
- Interdependent Capability (able to work as a team but capable of taking own initiative)
• Requirements:
• At least 21 years of age
• Preferably a European citizen
• English fluency recommended
• A team player
• Experience as a staff and/or a leader in a CISV International program desired
• A keen observer
• Capable of remaining neutral
• Attendance during the Training Days is a must
Family Name
Forename
Date of Birth
CISV Chapter
Previous CISV Experience
*Dietary requirements
*Allergies
Applicant´s Email

Telephone Number
Attitudes, Skills and Knowledge to offer to the project
Personal Reasons for participating in the Project
Applicant´s Signature
Sources for the letters of Recommendation
“Travel is fatal to prejudice, bigotry, and narrow-mindedness,
and many of our people need it sorely on these accounts. Broad,
wholesome, charitable views of men and things cannot be
acquired by vegetating in one little corner of the earth all one's
lifetime.”
- Mark Twain
1. Authorization for the facilitator to participate in the Peace Train Europe
I understand that joining the Peace Train Europe Project does entail having a set of responsibilities in respect to
the Project, the participant group, their families and to my fellow facilitators.
I am also aware that a background check is necessary and I will provide a current one not older than 6 months
together with my application.
2. Authorization and appointment of the adult facilitator
I accept the role as an adult facilitator present as a temporary guardian of the participant for purposes of
decisions regarding medical treatment and safety of the participant in the period stated. I will act in accordance
to Privacy and other laws that govern temporary guardianship of youth.
3. Authorization for unsupervised free movement

I will allow the participants to move freely in different settings with at least two other participants under the
condition in certain circumstances that allow it with an emphasis on my good judgement. It is not related to the
travelling periods wherein strict supervision is required.
4. Insurance
I hereby declare that I am insured with the policy number with attached copy of the Insurance: which will be
provided by the Organizing Team. The insurance would cover: Medical, Financial and Pay for Damage issues.
5. Permission to use of images, art and or written work
I agree that the project requires a thorough documentation and that would mean that the facilitators and
participants will be subjects and authors of various media. There will be several social media outlets running,
published work in local press, a published book in the end, and a fully edited video. The participants and
facilitators will be identified by first name or nickname, age and nationality. I fully understand that since the
documentation is extremely important, I give my full permission to the use of images, art and or written work
wherein I am either subject or authors of.
6. Permission to partake in swimming and other water activities, first Aid and Life Saving Swimming skills.
I understand that I may have to partake in swimming or other water activities and I give my own estimation of
my swimming capabilities.
Poor Fair Good
Life Saving Swimming Skills
I am capable and sure in administering lifesaving
skills in the realm of swimming
First Aid Skills
I am capable and sure in administering first aid skills
Yes No Yes No
* Please provide certificates to demonstrate them.
7. Medical Disclosure
I agree to give full accurate and current medical disclosure of my person, in English with the contact details of
my physician, with an attached Health Form when necessary. This may be evaluated by the Organizing Team
before the start of the Project and will be treated in accordance to medical privacy laws.
8. Arrival after the start of and/or early or late departure from the Peace Train Europe
The planning team and the facilitators understand that sometimes there are unavoidable conflicts in life and,
for extenuating circumstances, flexibility can be offered, so long as it does not negatively impact the trip nor
the participant’s safety. It will be made sure that all delegates arrive/leave at a time that works for the trip
logistics and as close as possible to each other, timewise, to make it easier for the Peace Train Europe or local
chapter members to pick them up from or drop them off at the airport, train or bus station.
Delegates can arrive/depart a day or so early due to extenuating circumstances (ie a final exam) if and only if:
•they have plans for pick-up or drop-off and a homestay, if arriving early or departing late;

•it is acknowledged that neither the local association, the Peace Train Europe organizing team nor Peace Train
facilitators are responsible for the participant’s welfare if they arrive early or depart late;
•pre-arrangements (including travel details, names & contact information of person with whom they are
staying, etc.) have been approved by the local association’s risk manager.
9. Direct pick-up of a participant to and from Peace Train Europe
The Peace Train Europe facilitators are responsible for the safety of the youth on the program from the time
the child arrives at the start destination until the participant departs at the end destination. If I give written,
detailed consent ahead of time, the participant can be released to the care of a responsible adult who can
show government-issued photo identification matching the information in the written consent.
10. Attendance during the Training Weekend
I understand that I need to attend the training weekend and not doing so may compromise my application. If I
am physically unable to participate due to work/scholarly reasons, I will communicate it as soon as possible in
order to organize an alternative training possibility.
*Please do refer to the PTE Project Guide for any questions.
** Do send a digital copy of the filled form to peacetraineu@gmail.com
I hereby give my consent to participate in the Peace Train Europe and agree to all the Terms and conditions
Date
Place
Emergency Contact’s Email
Emergency Contact Number
Applicant’s Signature