2026 CISV USA Austin Chapter Youth Delegate Application Form

YOUTH DELEGATE APPLICATION FORM
YOUTH APPLICANT INFORMATION
Name

First NameLast Name
Program (select what program you are applying to)
Gender Identity
Birth Date (Month/Day/Year)

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState & Zip Code

Postal / Zip Code
Home Number
Cell Number
E mail Address
School
Grade Level
School Principal's Name
Would the applicant like to be considered for CISV programs that take place in the summer of 2026 only, the winter of 2026 only or both? (Generally, summer programs are more competitive than winter programs so you increase your chances of getting a spot by being open to both summer and winter programs.)

Winter 2026 onlySummer 2026 onlyBoth Winter and Summer 2026
Language Ability (indicate speaking, reading, listening with understanding):
Language
Language Ability

ReadingListeningSpeakingFluent
Language
Language Ability

ReadingListeningSpeakingFluent
Language
Language Ability

ReadingListeningSpeakingFluent
Language
Language Ability

ReadingListeningSpeakingFluent
What are your interests and hobbies?
What are your activities outside of school?
How did you learn about CISV?
Have you attended sleepaway camp before?
What did you like and dislike about sleepaway camp?
Describe any other experiences away from home without your parents.
How do you imagine you will feel about being away from your home and family for several weeks?
Please list any domestic or international CISV Programs you have done.
Please list your Junior Branch activities and any other leadership experience you have.
PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN 1
First Name
Last Name
Address

Street Address (if different from applicant)

Street Address Line 2

CityState & Zip Code

Postal / Zip Code
Occupation
Employer
Home Number
Cell Number
Office Number
E mail Address
PARENT/GUARDIAN 2
Name

First NameLast Name
Address

Street Address (if different from applicant)

Street Address Line 2

CityState & Zip Code

Postal / Zip Code
Occupation
Employer
Home Number
Cell Number
Office Number
E mail Address
CISV requires that both custodial parents/guardians sign this application form (see last page for signature lines), thus confirming that the applicant has permission from both custodial parents/guardians to travel.

If an applicant is selected, all additional required CISV forms can be signed by just one custodial parent/guardian, unless CISV is informed in advance of custody issues that make necessary the signatures of both.
Check the option that best describes your situation:

Parents/guardians are married.Parents/guardians are divorced and share legal custody.Parents/guardians are divorced and one has full legal custody.Parents/guardians are not married but share legal custody.Parents/guardians are not married and one has full legal custody.Non-parent legal guardian has full legal custody.Other
If one parent/guardian has custody, name of that person:
* Documentation of full legal custody must be provided.
Why do you want your child to participate in CISV?
Parent/Guardian 1 Response
Why do you want your child to participate in CISV?
Parent/Guardian 2 Response
What are your current volunteer activities?
Parent / Guardian 1 response:
Parent / Guardian 2 response:
Will you be able and willing to volunteer with CISV if your child is selected?
Parent/Guardian 1 Response
Parent/Guardian 2 Response
If yes, which committee would you like to serve on? For a description of each committee, click here
CISV Committees:

HostingSendingRecruitingSelectionFundraisingMini CampSelection NightLocal Leader TrainerCommunications/Website/PR
Child’s Medical History

Does your child take prescription medications? If yes, please elaborate. List any allergies or health or dietary restrictions and their effect on your child's daily activities below. If your child is selected, a physician's declaration of your child's health and fitness for CISV participation will be required.
Allergies / Medications
Is the cost of this program a barrier to your participation and if so, would you like to apply for a scholarship? The answer to this question will not be considered in the selection process.
NATIONAL CODE OF CONDUCT AGREEMENT

To be read and agreed to by the youth applicant.

I agree to participate fully in any program I am selected for. I will abide by the guidelines established by CISV International, INFO FILE R-7 (9008), in such manner that will enhance our life together and foster courtesy and understanding between us all. I will not bring or use illegal drugs.

In all cases I will observe the wishes of my host family regarding drinking and smoking as a matter of courtesy. I will observe such sexual mores and behaviors that will not embarrass or injure others (such behaviors having been discussed with my parents/guardians). I understand I will be expected to participate in all CISV activities (games, culture sharing, crafts, singing, dances, meetings and workshops, etc.) and I agree to participate to the best of my ability. I further agree to represent my CISV Chapter in a manner that is consistent with the values of my home, community and country.

I understand that if I break my agreement, I may be removed from the program at my own expense.
Code Of Conduct Agreement

I understand and agree to follow this Code of Behavior. I understand that if I don’t follow this Code, there may be serious consequences: I may have to leave the CISV activity or program and I might lose my CISV membership temporarily or forever.
NATIONAL TRAVEL POLICY

1) Delegations shall travel to and from the site of the approved CISV activity as a group. Travel shall be direct and continuous to and from theCISV activity site. No side trips shall be permitted. No layover in excess of 24 hours shall bepermitted unless common carrier schedules require otherwise. Delegation itineraries mustbe approved by the local Chapter.

2) Penalties - Violations of Section 1 will result in disciplinary action against the Chapter orSteering Committee pursuant to the complaint procedure (83-BOT-2) of CISV, Inc.

3) Individual travel (as in the case of Junior Counselors and Seminar Camp and YouthMeeting participants) other than to and from the site of an approved CISV activity shall bedeemed non-CISV travel. CISV assumes no responsibility or liability for an individual whileon a side trip or layover in excess of 24 hours
IN SIGNING THIS APPLICATION, WE (APPLICANT AND PARENTS/GUARDIANS) CONFIRM THAT:
We have read, understand, and agree to abide by the National Code of Conduct Agreement and the CISV USA Travel Policy.
The information we have provided in this application may be verified by contacting individuals and agencies other than those listed in this application.
We release and hold harmless any individual or organization that provides additional information about us to CISV. We also hold harmless any officers or volunteers of CISV International, CISV USA, or the local Chapter of CISV.
All information provided on this application is true and correct.
SIGNATURES
Applicant

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Parent/Guardian 1

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Parent/Guardian 2

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Parent Commitment Form

How can CISV operate these complex programs as an all-volunteer organization?
Who does the work?

Volunteers like you and me! Thousands of dedicated people devote many hours to CISV programs around the world because they have experienced the special, rewarding feeling that comes from making new friends around the world and learning about other cultures and ways of life. These volunteers want others to experience the same feeling, and they want to give something back to the organization that means so much to them and to their children. When your family becomes involved in CISV, parents will have the responsibility to serve as a volunteer in some capacity. There are dozens of jobs that must be done… some big, some small, but all are very important to our success. We must have families who are willing to do their share so all the work is not done by just a few. We hope you too, will be a part of CISV and see why so many care so much!

In order for a child to be considered for selection as a delegate for a CISV program, their family commits to the following minimum volunteer activities on behalf of the Austin/San Antonio Chapter for the year in which their child is attending a program:

1. Officially join the CISV Austin San Antonio Chapter using the website CISV Central

2. Attend all meetings of your child’s delegation that include parents;

3. Do your family’s fair share of the work for your child’s delegation;

4. Complete and submit all required insurance and health forms by the due date;

5. Support your child’s adult leader

6. Attend the Spring and Fall General Membership meetings;

7. Attend and support the Fundraisers

8. Host a delegate for our current year hosting program(s) for a period of 2-3 days*.

9. Volunteer to help with the current year hosting program(s);

10. Help recruit delegates and leaders/staff members for future CISV programs;

11. Become an active member of at least one CISV ATXSA working committee.

* It is a special honor to host a delegation in your home. We have many long-time members of CISV ATXSA who host delegations. There is a possibility that your family will not be assigned a delegation to host, but you should be prepared to host if asked.

I commit to the above minimum requirements.

Please sign and date below.
Parent Signature

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Parent Signature

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YOUTH DELEGATE APPLICATION FORM

YOUTH APPLICANT INFORMATION

PARENT/GUARDIAN INFORMATION

IN SIGNING THIS APPLICATION, WE (APPLICANT AND PARENTS/GUARDIANS) CONFIRM THAT:

SIGNATURES