AfL5 online application | Action for Life

With some requests, the postponed final date for submitting an application is 31st March 2010.

All required documents must be submitted before this date. Please complete the form in full. Personal information will be kept confidential.

Title: *

Family name as on passport: *

Given name(s) as on passport:: *

Name which you prefer to be called:

Permanent postal address

Street: *

Town: *

Postcode: *

Country: *

Phone (include national and area codes): *

Mobile phone (optional):

Skype id (optional):

Fax (optional):

Email: *

Date of birth: *

Country of birth: *

Citizenship: *

Gender: *

Current study or work situation: *

First language: *

Other languages:

The main communicating language of Action for Life will be English. Please give your considered and honest response to the following questions:

Is your spoken English: *

Is your understanding of written English: *

Please give the names and contact details of two people, active and responsible in Initiatives of Change, who can act as reference people:

Person #1: *

Person #2: *

Insurance: *

I agree to obtain medical / travel insurance for the duration of AfL5 before departure.

Do you have any long-term health problems or disability?: *

Are you, or will you be, on any regular medication?: *

If 'yes' to either, please give details:

Expectations of all participants in the program: The Community Contract during the duration of AfL5

Action for Life will operate as a community, with teamwork across generations and cultures, with respect for and sensitivity to each other, and with openness and a sharing of responsibility in all we do. Its effectiveness, and what we communicate to others, will depend on the quality of our individual and corporate living, our commitment and our spirit. A foundation for this quality in our community will be the daily practice of listening and responding to the inner voice of God or conscience, and a willingness to explore the spiritual dimension and morality as a guide to integrity. Outward disciplines also are important to the community. For the sake of the action we undertake and for our community spirit, there is an expectation that participants will abstain from the use of alcohol, tobacco and drugs, and from exclusive or romantic relationships during the duration of AfL5.

Confirmation: *

I am willing to accept these expectations.

General conditions:

If valid reasons or circumstances arise, an individual's participation in the Action for Life program can be ended at any time either by the Coordination Team or by the person concerned, in consultation with each other. If for any reason a participant withdraws, a partial refund of fees paid (up to US$ 1,000) may be made to the original source of that funding. No refunds will be made after 2 months.

The participation fee is US$ 2,500.

I hereby agree to these conditions and, if accepted for the Action for Life program, undertake to obtain adequate medical / travel insurance for the duration of the program before departure. I understand that Initiatives of Change is not responsible for any loss, injury or damage suffered by me or to my property as a result of participating in the program and agree to release Initiatives of Change from all liability for any such loss, injury or damage.

Please check box and enter your name and today's date, to indicate your agreement: *

I agree

Name: *

Before submitting the form, please check that you have filled in all fields, and checked the three boxes agreeing to travel / medical insurance, expectations of all participants, and general conditions.

Once you have sent the online application, we will email you. This email will ask you to gather and send in additional documentation.

You will then need to complete and send in by email;

CV (curriculum vitae): details of your hobbies, interests, special gifts or talents, personal studies, service and employment of no more than 2 pages.
Two references with contact information of referees. Referees must be active and responsible in Initiatives of Change. The references should be around 100 words and answer the following questions: Why do you recommend this applicant for AfL? What experience with IofC does this applicant have?
500 word essay about your:
- expectations and hopes of the program;
- reasons and motivation for wanting to participate in this program;
- and previous and/or current participation in Initiatives of Change activities
200 word essay on the question: "What is the issue or need of your
country that you would like to use the IofC training that AfL5 will give,
to answer? Please give us some description of the issue/need and what will be the way you would make a start with that? Or what have you already been doing in your life to work towards a solution to this problem?"
Photo of yourself. The photo should be in JPG format and no bigger than 60KB.

Please Note: All documentation needs to be in English. Thank you for your understanding.

Please ensure that no documentation is missing, so that your application can be processed.

(Your full application will not be processed until these have been received.)

If you have completed the online application and you do not hear from us within one week, please contact us.

A copy of your application will be sent to your email address for your records.

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