FWSCI Chapman Student Exchange Program Chaperone Application

Summer 2025 Chaperone Application

This application is for consideration to be selected as a chaperone for an international travel experience through the Fort Wayne Sister Cities International Chapman Student Exchange Program.
You are applying for an opportunity to travel alongside youth to provide them with a supported, positive, and safe experience. This is not a vacation to one of our sister cities. Ideal candidates have the following qualifications:

- Minimum age of 25.

- Current/previous experience working with youth.

- Ability to obtain or hold CPR and first-aid certification valid through September of the travel year.

- Ability to pass a comprehensive background check.

- Availability to travel in June or July of the exchange year.

- Must hold or be able to obtain a passport with an expiration date no sooner than January 1st of the year succeeding the travel year.

Please note, for this application you will be required to complete application, collect two letters of recommendation, a signed copy of the FWSCI Primary Chaperone Requirements & Responsibilities, and submit an updated resume before submitting this application form. See our website for more information and to download our letter of recommendation forms.

Please email exchange@fwsci.org with any questions.

PLEASE DO NOT SUBMIT THIS FORM UNTIL YOU HAVE ALL REQUIRED COMPONENTS. All applications must be received by 11:59pm on January 10, 2025 for interview on January 16, 2025 between 4:00pm - 6:00pm. Applications submitted after this date will be scheduled for interview at a later date if spots are still available for the travel year.
Name of Applicant*

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Email*
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Phone Number*
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Address

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Date of Birth*

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Gender*

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Are you a permanent resident of Fort Wayne or Allen County?*

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Occupation*
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Contact In Case of Emergency
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Address

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Applicant Questionaire
Describe your experience(s) working with youth:*
Identify any previous/current Sister Cities relationship/experiences:*
Identify and explain your most significant leadership experience(s):*
Have you had previous international travel experience? What was the duration and countries visited? How has this experience(s) influenced your life?*
Applicant Native & Foreign Language Skills
Native Language(s)*
Non-Native Languages Studied:
For each language, please include the number of years studied and the proficiency of speaking, reading, and writing on the scale of - poor, fair, good, fluent.
Applicant Materials

Please insure that you include all materials requested. Please visit our website for the correct format of our letters of reference as well as the Primary Chaperone Requirements & Responsibilities.
Resume:*

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Letter of Reference 1:*

Note: This must be on our form found at: https://www.fortwaynesistercities.net/s/2024-FWSCI-Chaperone-Reference-1.pdf
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Letter of Reference 2:*

Note: This must be on our form found at: https://www.fortwaynesistercities.net/s/2024-FWSCI-Chaperone-Reference-2.pdf
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Primary Chaperone Requirements & Responsibilities:*

Please include a signed PDF of this document.
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Acknowledgment
I hereby declare that the information I have provided above is true and correct to the best of my knowledge. I understand that any misleading or false information I provide that was substantial to the consideration of my application shall cause the termination of my participation in the program.

Please Note: Application materials may not be submitted outside of this application portal. All applicants will receive a submission confirmation email. Please note if you do not receive a confirmation email, then we may not have received your application and a new application should be submitted.
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Summer 2025 Chaperone Application

Contact In Case of Emergency

Applicant Questionaire

Applicant Native & Foreign Language Skills

Applicant Materials

Acknowledgment