International Peacemaker Request Form
2017 International Peacemaker Dates: September 22 - October 16

International Peacemakers, a ministry of the Presbyterian Peacemaking Program, invites leaders from our partner churches around the world to share their experience as peacemakers. Understanding peace and justice concerns of others around the world will inspire, equip and connect Presbyterians in transforming cultures of violence into communities of peace. The itineration of International Peacemakers is intended to enhance the ministry of PC(USA) mid-councils, colleges, seminaries and institutions.

This year's International Peacemakers come from:
Guatemala, Italy, Kenya, Malawi, Mexico, Myanmar, Northern Ireland, Pakistan, Palestine, Philippines , Sierra Leone, South Sudan, Sri Lanka, Ukraine, Venezuela and Vietnam

They will bring unique experiences and stories from their work in the following areas:
a. Addressing the root causes of poverty, particularly as it impacts women and children
b. Working for healing and reconciliation in cultures of violence and brokenness
c. Sharing the Good News of God’s love in Jesus Christ
d. Responding to natural and human-caused disasters
e. Embodying and advocating for God’s vision of a just and peaceful world

Cost: $450.00 (All airline travel is included. Hosting entities plan schedules in their regions and provide housing, local transportation, and all meals)

Applications will be received until July 1, 2017. Requests will be honored on a first-come, first-served basis, with preference given to first-time requests and those who have not hosted an International Peacemaker in recent years. After July 1, a few peacemakers may still have availability in their schedules. Please contact the Peacemaking Program for details.

MID-COUNCIL INFORMATION
Please note that the Presbyterian mid-council (presbytery and/or synod) in your region must be aware and involved in the International Peacemaker's visit to your area.
Mid-Council
Your answer
Name of Mid-Council Contact
Your answer
Best phone for mid-council contact
Your answer
Best E-mail for mid-council contact
Your answer
Is the Mid-Council aware of this request to host an International Peacemaker?
PERSON FILLING OUT THIS FORM
Last Name
Your answer
First Name
Your answer
Best phone
Your answer
Best email
Your answer
Street mailing address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
ADDITIONAL CONTACT PERSON (If applicable)
This is an additional person who will be included in all correspondence about the International Peacemakers
Last Name
Your answer
First Name
Your answer
Best phone
Your answer
Best email
Your answer
City
Your answer
State
Your answer
Zip
Your answer
INTERNATIONAL PEACEMAKER REQUEST
International Peacemakers ordinarily visit for 3-5 days, but the visits can be extended if needed. Please note that arrival and departure days are not included and are considered "travel days." International Peacemakers are available from September 22 - October 16, 2017.
1st CHOICE ARRIVAL DATE
Please provide us with the date you would prefer the peacemaker to arrive
MM
/
DD
1st CHOICE DEPARTURE DATE
Please provide us iwth the date you would prefer the peacemaker to depart
MM
/
DD
2nd CHOICE ARRIVAL DATE
Please provide us with the date you would prefer the peacemaker to arrive
MM
/
DD
2nd CHOICE DEPARTURE DATE
Please provide us with the date you would prefer the peacemaker to arrive
MM
/
DD
3rd CHOICE ARRIVAL DATE
Please provide us with the date you would prefer the peacemaker to arrive
MM
/
DD
3rd CHOICE DEPARTURE DATE
Please provide us with the date you would prefer the peacemaker to arrive
MM
/
DD
Please describe any other particularities of your date selection that would be helpful for us to know.
Your answer
COUNTRY/PEACEMAKER SELECTION: 1st Choice
COUNTRY/PEACEMAKER SELECTION: 2nd Choice
COUNTRY/PEACEMAKER SELECTION: 3rd Choice
Which is more important to you? The country of your peacemaker or the dates for the visit?
ACCOMMODATIONS AND ARRANGEMENTS
The following information helps us build the peacemakers' itineraries and plan for their visits.
ARRIVAL AIRPORT PREFERENCE: 1st Choice
Please provide the name and EXACT airport code for the selected airport, for instance "John F. Kennedy Airport, New York - JFK"
Your answer
ARRIVAL AIRPORT PREFERENCE: 2nd Choice
Please provide the name and EXACT airport code for the selected airport, for instance "John F. Kennedy Airport, New York - JFK"
Your answer
DEPARTURE AIRPORT PREFERENCE: 1st Choice
Please provide the name and EXACT airport code for the selected airport, for instance "John F. Kennedy Airport, New York - JFK"
Your answer
DEPARTURE AIRPORT PREFERENCE: 2nd Choice
Please provide the name and EXACT airport code for the selected airport, for instance "John F. Kennedy Airport, New York - JFK"
Your answer
Housing
The International Peacemaker will most likely be housed in (select all that apply):
Required
Housing in a Private Home or Residence
If your peacemaker will be in a private home or residence, does the home have (select all that apply):
Anticipated Audience (select all that apply):
During the visit, the International Peacemaker will most likely provide leadership with the following groups:
Required
How many different presentations or speaking engagements do you anticipate the Peacemaker will make during the visit?
What can we share with the International Peacemaker that would be helpful to know about your group or organization?
Your answer
Describe the initial plans for the International Peacemaker's visit.
Your answer
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