CHILDREN’S INTERNATIONAL SUMMER VILLAGES

AN INDEPENDENT, NON  -  POLITICAL, VOLUNTEER ORGANIZATION PROMOTING PEACE EDUCATION AND CROSS - CULTURAL FRIENDSHIP

Confidential Reference Form for IPP Participant

(The only official text for this form is this English edition.)

SECTION 1.      APPLICANT’S INFORMATION  (To be filled in by Applicant)

SECTION 2.      FOR REFEREE TO COMPLETE

Dear Referee, the person named above has applied for a volunteer leadership position in a CISV programme. He / she will work with individuals from several nations and cultural traditions in the context of one of the programs described below:

MOZAMBIQUE: Sustainability in developing and developed countries

This IPP will focus on the needs of the community consisting of 400 individuals, and of the projects already being developed by the partner organization. The participants will be working on three different projects such as creating a green house together with the partner organization and the women of the community. In the second project the IPP group will identify/label trees and set a path along the labelled trees in order to use tours in the forest as a tool for promotion of Dondos landscape. Furthermore the participants will hold an educational workshop to provide tools not only to work with the children of the community creating awareness of the environment and healthy habits of hygiene, but also develop workshops of educational content for the guides of the forest.

PHILIPPINES: Indigenous People/Livelihood for sustainable development

The Mangyan Mission has been involved with the 8 Mangyan tribes, helping them with the preservation of their culture, education and livelihood. The proposed IPP in the Philippines will focus on the sustainable development of a particular indigenous people, the Mangyan tribes of Mindoro. Guided by the CISV peace education circle and its principles, we hope to explore ways in achieving sustainable development through their environment or natural resources. >From coming to understand celebrate the richness of their culture, we will also try to help preserve the heritage that is uniquely Mangyan, even with the integration of modernization into their traditional approaches and processes of livelihood. Participants will assist volunteers and the Mangyan locals associated with the heritage center on various projects.

CISV thanks you for your assistance in selecting appropriate personnel for CISV’s international peace education programmes. Your response will be treated as private and confidential and destroyed as provided by law.

As a guide for the Referee, CISV does not consider persons exhibiting the following behaviour to be appropriate for a position of leadership: alcohol / drug abuse, serious criminal convictions, dishonesty, emotional or behavioural disturbance, prejudice, sexual abuse, violence, lack of self control, intolerance, or the inability to appropriately deal with stress.

REFEREE’S INFORMATION

In my opinion, CISV  would / would not (strike out or delete as appropriate) benefit by having this Applicant in a position of responsibility in its cross-cultural and international peace education programmes for the following reasons:

Special skills or other comments:

Declaration:

To the best of my knowledge, the information I have provided about the Applicant is true, accurate and complete. I am not aware of past/present behaviour by the Applicant that would disqualify him/her from working with international youth, acting as an appropriate role model or functioning in a position of trust with CISV.

Confirmation of previous Reference:

Please sign here if you have provided the above reference for this Applicant before and are confirming that what was said in the previous Reference remains true and that your opinion on the matter has not changed.