Application for the 2004 Humanitarian Delegation to Colombia
Chicagoans for a Peaceful Colombia and Fellowship of Reconciliation
Cacarica, July 18-August 7 San José de Apartadó, July 18-31
We are delighted that you are interested in visiting Colombia! You are in for an exciting and rewarding adventure. The people of San José and Cacarica are awaiting our visit eagerly.
Please be aware that the delegation won't be a vacation. Our days will begin and end with delegation gatherings to prepare, address problems, and debrief our experiences. While we are in the cities (Bogotá and Medellín) we will be attending meetings, up to three a day, with NGOs and community organizations; before returning to the U.S. we will also meet with government officials and people from the U.S. Embassy. Getting to the community may involve riding muleback, sitting on a low plank seat in a canoe for a couple of hours, and/or wearing rubber boots to hike through mud. We will have to contend with heat, humidity, unfamiliar food, mosquitoes, cockroaches, and last-minute schedule changes.
Sounds like fun, doesn't it?! Seriously, it will be great fun — but we all need to prepare well, physically, emotionally and spiritually. Upon acceptance of your application, you will be sent materials that will help with your preparation and with raising funds to pay your way. We look forward to getting to know you and learning along with you.
DELEGATE APPLICATION
CHOOSE ONE: ___ Cacarica, July 18-August 7 ___ San José de Apartadó, July 18-31
Candidates for the delegation must complete this application form and mail it to Liza Smith,
with your $100 deposit to Liza Smith, 5329 Dryades St. Apt C, New Orleans, LA 70115.
(write check to "Fellowship of Reconciliation").
Applications will be accepted between February 1 and May 18, 2004.
I. PERSONAL DATA
1. Name ______________________________________ 2. Date of birth ________________
3. Address _________________________ City_______________ State _____ Zip ________
4. Telephone _____________________ (day) ____________________ (evening)
5. Passport # ____________________ 6. Occupation ______________________________
7. Education ______________________________________ 8. Gender ___ Male ___Female
9. Email address __________________________________ 10. Fax # __________________
II. EXPERIENCE
1. Have you traveled to Latin America/the Caribbean? Yes _____ No _____
If yes, briefly describe your travel experience: _________________________________________________
2. Spanish language ability: Excellent _____ Good _____ Fair _____ Poor _____
3. What is your experience with solidarity organizations or other groups working on Latin America and/or social justice issues?
4. How did you hear about Chicagoans for a Peaceful Colombia and/or FOR? Why do you want to participate in this delegation? What are your personal goals for the trip? (Continue writing on back of page if you wish.)
5. Please describe other aspects of your background which would help us get to know you. This may include other jobs, special skills, volunteer commitments, organizational affiliations, travel experience, cross-cultural experience, avocations, and any experience in Latin America. Feel free to attach a C.V. and/or brief biographical document that you may have already.
6. After returning from Colombia, delegates are expected to spread the word about what they observed and learned. What ideas do you have for your own follow-up (e.g., writing or speaking, to what constituencies)?
III. HEALTH INFORMATION
"Negative" answers to the following questions will not necessarily prevent you from participating in this delegation, but will help us in assessing your special needs and allow us to take measures to reduce the risk of serious health problems during the delegation. Please note that Chicagoans for a Peaceful Colombia and FOR are not responsible for serious health problems that may occur. Check with your healthcare provider to ensure that you have health coverage during your travels (if not, you will need to purchase travel insurance).
1. General health: Excellent _____ Good _____ Fair _____
2. List any allergies, disabilities, diabetes, heart conditions, other health-related problems:
3. Do you have a history of drug and/or alcohol abuse? Yes ____ No ____
If so, please describe.
4. Have you been hospitalized for an emotional or mental illness within the last year?
Yes ____ No ____
If yes, please explain.
5. Are you currently under a physician's care or receiving prescribed medication?
Yes ____ No ____
If yes, please explain.
6. Do you have any particular dietary needs (e.g., vegetarian)? If so, briefly explain.
7. How well do you handle stress? Please describe.
IV. VALUES AND BELIEFS
1. Are you a member of a church, synagogue or other spiritual organization? If so, which one?
2. What is your position on and experience with nonviolence?
V. PERSONAL REFERENCES AND EMERGENCY CONTACT
1. Please provide two references — friend, coworker, mentor, etc.
Name __________________________________ Telephone ____________________________
Name __________________________________ Telephone ____________________________
2. Please provide an emergency contact. (Make sure this person knows to contact Fellowship of Reconciliation, 415-495-6334 or forlatam@igc.org, if they have an urgent need to get in touch with you while you're in Colombia.)
Name __________________________________ Telephone ____________________________
Applicant Signature ____________________________________ Date ___________________
Thanks for your application! Please understand that spaces in this delegation are limited, and that for this reason or others, Fellowship of Reconciliation and Chicagoans for a Peaceful Colombia may not be able to approve all applications. We will be in contact with the persons you have named as references, and we'll have a response for you within two weeks of receiving your application. Your deposit will be refunded if your application cannot be accepted; otherwise it's nonrefundable.
