Formulario

UConn Empower - Trip Member Application for Winter 2014-2015 Trip to India

Please complete and submit by 11:59 pm on Wednesday, April 30, 2014.

Trip Information
UConn Empower will be travelling to a small village close to Rishikesh, India to work with the Amar Jyoti School. It is an organization that provides a free education to impoverished children who cannot afford to attend school. Our goal is to enact long-term changes to the school that will improve the curriculum, the children’s experiences, and community around the school. The trip will run approximately two weeks between the end of December and the start of January.

The school is run by Mr. Rashmi Kant, who also works as tax auditor. He and his wife use the funds that he earns from his job as well as donations to help 60-70 kids get the closest thing to a quality education. They have two students from a local high school who help run lessons as volunteers. UConn Empower plans on helping Mr. Rashmi Kant in his mission to educate the underprivileged by enacting long-term education initiatives. More information can be found on their website.

Safety Details
Safety is a legitimate concern for any international trip. In response to that, UConn Empower has talked with the director of the school, as well as conducted independent research of the area and contacted personal sources that live in the area. The area is safe, the nearest police station is 1 kilometer away from the school. The nearest hospital is 12 kilometers away from the school. The school, which is where we will be staying is surrounded by a concrete wall of about ten feet. There has been no history or robbery or assault in the area. In talking to another volunteer who worked there, no security threats were encountered. We will not be going in any major cities, unless it is to go to the airport or to simply pass through. The majority of our time will be spent in the small village where the school is-minimizing the risk of crime.

Overall, the area has been confirmed to be safe by both the director and an outside volunteer (who is from Austria). UConn Empower will have a satellite phone and cell phone to make international calls for the trip members to stay in contact with family and loved ones. All of the board members going on the trip have been on trips before and are experienced. A chaperone experienced in international travel will also be accompanying us on the trip.

Traveler Requirements
1. Traveling to India involves applying for visas. This requires participants to submit materials including: passports, proof of address, passport-style photos, and a visa application. Those under the age of 18 also need to submit a copy of their birth certificate, a notarized consent from both parents, and copies of certain pages in parents' passports. We will give information about the entire process and assist travelers completing the application.
2. Trip leaders/participants will also need to get vaccines to travel abroad. This involves a visit to a local travel clinic. Vaccines that will be recommended may include those for Yellow Fever, Hepatitis A, Hepatitis B, Meningitis, Typhoid, and Tetanus.
3. The estimated cost of this trip is $1500 (with a maximum of $1,650), which includes airfare, food, housing, travel insurance, transportation, visa fees, and hosting a chaperone. We will assist members in paying for the trip by providing letter templates to ask for support and helping travelers with personal fundraisers.
4. There were be meetings two to three times a month to develop the team and prepare for the trip. These meetings are mandatory for trip participants and will be held on the following Saturdays:
  - August 30th
  - September 13th
  - September 27th
  - October 11th
  - October 25th
  - November 8th
  - November 29th
  - Meetings will generally be from 2:00 pm - 3:30 pm. Two of these meetings will be longer and will involve a ropes-course activity and a volunteer service trip.
5. The deadlines for trip materials are as follows:
  - Visa materials by Saturday, August 30, 2014
  - Trip deposit of $200 on by Saturday, August 30, 2014
6. Becoming a member of Empower if you are not already and attending general body meetings are required. Travelers will be working at least once a week with the club, other trip members, and the Executive Board to design trip and fundraiser initiatives for the Amar Jyoti School. This is a significant extra time commitment, with the workload being equated to another 2 or 3 credit class.
7. UConn Empower does reserve the right to remove anyone from the trip without refund of their deposit. This will be in response to a lack of commitment to any of the pre-trip meetings and activities.
8. This application is open to both UConn Empower student members and non-members. However, all applicants must be full-time undergraduate students at the University of Connecticut. Current membership and previous participation in UConn Empower will be factored into the selection process. Non-members, however, are highly encouraged to apply as they can be picked over members on merit.
9. After the general application process, desirable candidates will be selected for interviews with the Executive Board.
If you have any questions, comments, or concerns about the application, deadlines, requirements, or meetings please contact us at uconn.empower@gmail.com.

Application Information

Background Information
Official Name*

First NameMiddle InitialLast Name
Date of Birth*

MonthDayYear
University ID*

Student IDNet ID
Campus*

StorrsOther
Degree*

Major(s)Minor(s)Expected Graduation Month
I am a citizen of*

Personal Contact Information
Permanent Address*

Street Address

Apartment Number (If Applicable)

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*

Parent/Guardian Contact Information
First Parent or Guardian*

First NameLast NameRelationship to Traveler
Daytime Phone*

Area CodePhone Number
NighttimePhone*

Area CodePhone Number
Second Parent or Guardian*

First NameLast NameRelationship to Traveler
Daytime Phone*

Area CodePhone Number
NighttimePhone*

Area CodePhone Number

Short Answers
1. Describe one experience in which you personally took an initiative in any way to help a community. (We recommend you type your response in another file and paste it into the form afterwards. The form will be saved in your browser for two days.)*
2. Describe an instance of conflict or disagreement with another person. How did you respond in the situation? (We recommend you type your response in another file and paste it into the form afterwards.)*
3. What do you hope to personally get out of this trip? (We recommend you type your response in another file and paste it into the form afterwards.)*
4. What other activities do you participate in on campus?*
5. Have you ever worked or volunteered with a group or non-profit organization before? If so, in what capacity was your involvement?*
7. Have you ever travelled outside the US?*

YesNo
If you answered yes, where and when?
Do you have the time to commit to the biweekly meetings for the trip team as well as the weekly general-body meetings for UConn Empower?*

Expectations for Trip Participants
Please check off to acknowledge the following trip particpant guidelines:*

I confirm that I have the time to attend Empower’s weekly general-body meetings.I understand the obligation to submit all visa materials by August 30, 2014.I agree to pay the $200 trip deposit by the August 30, 2014.I understand that the deposit for the trip is nonrefundable.I understand that I will not be reimbursed for the trip cost if I withdraw from trip for any reason after October 10, 2014.
I affirm that I will provide the necessary monies and materials by the trip deadlines indicated in this application released on the 10th of April, 2014. I acknowledge that if I fail to adhere to any of the deadlines or guidelines laid out at any point through the application or correspondence with uconn.empower@gmail.com, I may have my spot on the trip revoked and my payments to UConn Empower refunded with the exclusion of the trip deposit (and any monies if after October 10th, 2014). UConn Empower reserves the right to revoke the privilege to participate on the trip at its discretion, based upon factors including but not limited to inability to work with other members, disregard for a pre-trip processes, or other behaviour that inhibits UConn Empower’s ability to travel safely and work effectively in India.*

Digital SignatureDate MM/DD/YYY
Should be Empty: