Staff-Leader Application Form
To be filled in by all persons applying for a position of responsibility (including staff, leaders, JCs, junior staff, junior leaders) in a CISV international programme and sent to the person responsible for staff/leader selection in the applicant’s home national association. For international staff positions, this form must be signed first by the person in the applicant’s home NA who is responsible for staff/leader selection and then forwarded by that person to the responsible member of the Host NA
Which CISV program are you applying for?
Program Hosted in Jacksonville (Step Up in 2022, Seminar in 2023, YM in 2024, Village in 2025)
Village (age 10-11)
Step Up (age 14)
Step Up (age 15)
Interchange (age 14-15)
Youth Meeting (age 12-13)
Local Programs (Faces, Family Exchange, Leadership & Service Camp)
Position applying for:
Jr. Staff (age 18-20)
Jr. Leader Interchange (age 18-20)
Year applying for:
Street Address Line 2
District of Columbia
Country of Residence
Applicant's Mobile Phone Number
Date of Birth of Applicant
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How do you self-identify?
Hispanic or Latino
Native American/Alaskan/Hawaiian or Pacific Islander
A racial/ethnic category not listed
Employer/Academic Institution (if student)
Educational Background (institution, degree & year):
Describe health restrictions and their effects on your daily life. Include food allergies, environmental allergies, chronic illnesses, mental & physical health restrictions, dietary restrictions, and simliar issues that affect your participation.
Are you fully vaccinated against Covid-19?
Upload vaccine card
List of foreign languages spoken and ability (fluent, good, or fair).
In the CISV program, you will need to assist and or assume responsibility for some activities such as music, arts and crafts, games, sports, dance, discussion and swimming. Please list your interests and skills, which could be helpful at the program:
Do you have certification in lifesaving
Do you have certification in first aid?
Please describe your experience working with people in a leadership role and as part of a team:
Please describe your CISV or other experience with children/youth (of similar age to the specific program participants):
Please describe other experience in CISV, with other intercultural organisations or with other cultures:
Why do you want to be a staff/leader or Junior Counselor?
Upload a photo of the applicant
Two references are required. Please share the CISV Reference Form to your References listed below and ask them to complete the online form.
Name of Reference #1
Reference #1 Phone Number
Reference #1 Email
Name of Reference #2
Reference #2 Phone Number
Reference #2 Email
Applicant -- Please certify that: I will participate in all CISV Leadership Training Sessions required by CISV. I will abide by and uphold CISV Guidelines on Behaviour and Cultural Sensitivity (Info File R-7) and will put the delegates’ interests and welfare above my own while attending the programme. I understand that before serving in a staff/leadership position, I must be a member of CISV. I have no criminal convictions or history of mental illness, emotional counselling, violent behaviour, child abuse, drug/alcohol abuse, prejudice etc that would disqualify me from participation in CISV’s international, cross-cultural and peace education programmes. I agree to a police record check if required by CISV. I consent to the personal data in this Application Form being used by CISV to process this application and agree that it may be shared with other people involved in organising the programmes, wherever they may be hosted. All the information on this application is correct and accurate.
EXPLANATION FOR STAFF-LEADER APPLICATION FORM
Please see the relevant Program Guide and CISV International policies on selection of persons with Program responsibility Info File R-05 Guidelines on Discrimination, Selection & Behavior.
The personal data provided in this form is confidential and will be kept and eventually destroyed according to the laws of the country holding the data. Staff, leaders and JCs must be members of their local CISV Chapter or National Association or join once they are selected, prior to the Program.
Staff must be the proper age on the first day of the Program. Leaders and JCs must be the proper age on the day of departure for the Program. Specifically:Junior Counsellors must be 16 or 17 years old. Interchange junior leaders must be at least 18 years old and it is recommended that there be at least four years between the participant age and the age of the junior leader. All adult leaders and staff must be at least 21 years old. At least one member of the staff of every Village, Step Up, Youth Meeting, Seminar Camp and IPP must be at least 25 years old. In Step Up, Village and Youth Meeting, where there are 4 or more adult staff members, there may be 1 junior staff from the hosting NA.Junior staff in a Village must be at least 19 years old. All staff and leaders must receive appropriate orientation and leadership training as specified in CISV International policies and guides.
Background Checks and References
Police checks. Unless local law forbids it, police checks are required for all staff/leaders (aged 18+) at all CISV International Program and activities. International Program staff: Please remember to follow the proper procedure and start the process very early as it will take some time to go through each of the steps. For NAs hosting IPP, Seminar Camp, Step Up, Village or Youth Meeting, in every case, the person responsible for staff selection in the host NA should send a formal inquiry to the home NA of the person they want to invite, asking if they may invite him/her. The home NA might refuse if they feel that they cannot recommend the person as a staff, or that they need the person for a Program at home. If this is the case, the home NA has the final say.· If the home NA agrees, the person in the host NA responsible for staff selection should send an invitation to the invited person with a copy to the home NA. The invitation must contain the Staff-Leader Application Form, two Reference Forms, as well as a clear statement regarding the following: (1) the position (Program Director or ordinary staff member), (2) any financial obligations, travelling conditions, etc., (3) relevant staff education/training, and (4) pre-and post- Program days For all international staff, an applicant for an international staff position for any Program must: (1) fill in a Staff-Leader Application Form and send it to the person in their NA who is responsible for staff selection, (2) ask two referees to complete the official CISV Reference Forms and forward them directly to the person in their NA who is responsible for staff selection. and (3) work with the person in his/her home NA who is responsible for staff selection to arrange for a police check (where possible according to national law) to be carried out and sent to that person for review. The person in the Applicant’s home NA who is responsible for staff selection should:·(1) review the Staff-Leader Application Form, references and police check and if all is satisfactory and the applicant is considered to be a suitable candidate, (2) sign the CISV certification in the Staff-Leader Application Form, (3) forward a copy of the Staff-Leader Application Form and the references (not the police check) to the person in the host NA who is responsible for staff selection, which indicates that the home NA is agreeing that the person may be selected for an international staff position.
International Staff Opportunities
Anyone interested in becoming international staff can check for international Program staff opportunities on www.cisv.org.
CISV Certification (to be signed by the CISV member responsible for staff/leader selection in the home NA of the applicant).
CISV Certification - Sign below if you certify that the above application, references and police checks (where possible according to national law) have been reviewed and found to be satisfactory so that the application is approved. For international staff positions, a copy of this form and references (not police check) should then be forwarded to the person in the relevant host NA responsible for staff selection. The signature tells the host NA that the home NA has followed the correct procedure and considers that the applicant may be selected as international staff.
Signature of CISV member responsible for staff selection
Date of Signature of CISV Member
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