2024 Youth Applicant Reference for CISV Pittsburgh
The following is a recommendation for a CISV Pittsburgh youth applicant. They have applied to participate in an international peace education program which will include youth participants from several nations and cultural traditions.

During the CISV program, the delegate will serve as a role model in the activities and work to create an environment where cross-cultural friendships and international cooperation are possible.

If selected, the youth delegate will represent both the United States and his/her own area.

The CISV Pittsburgh chapter requests your help in identifying applicants who exhibit leadership qualities and can represent their own culture successfully. For more information on specific programs, you can visit our website at https://pittsburgh.cisvusa.org/programs/

Your response will be treated as private and confidential. If you have any questions regarding the referral process, please contact pittsburgh@cisvusa.org.

THIS FORM MUST BE COMPLETED BY JANUARY 23, 2024.

IF REQUESTED AFTER THE DEADLINE, PLEASE SUBMIT THIS REFERENCE IN A TIMELY MANNER.

PLEASE CHECK WITH THE APPLICANT REGARDING THE SPECIFIC PROGRAM TO WHICH HE/SHE IS APPLYING.
Sign in to Google to save your progress. Learn more
Name of applicant you are referring *
The applicant is applying for (please check one): *
Required
Your Name *
First and last name
Phone number *
Email address *
Your occupation *
Capacity in which you know the youth applicant. Please provide a detailed answer. *
If you are the youth applicant's current teacher, what is the name of your school? *
What is your school's phone number?
Length of time you have known the youth applicant *
Please check all traits in the list below that you consider to be characteristic of the youth applicant *
Required
Use this space to elaborate on any of the traits checked above or to share any concerns. Keep in mind that we are looking for youth who complement each other when forming program delegations. There is no set profile of a "typical" or "ideal" youth delegate. *
Do you know of any special talents or experiences that would help this youth applicant contribute to an international program? *
To the best of your knowledge, does this youth applicant have any emotional or behavioral characteristics that would interfere with his/her successful participation in a CISV program? *
Behaviors that are never acceptable in any CISV program include illegal acts, alcohol/drug abuse, dishonesty, prejudice or intolerance, violence or lack of self-control, sexual contact, verbal abuse of others, and inability to handle a reasonable amount of stress. If you have seen the youth applicant exhibit such behaviors, please explain in the space below or email the Chapter contact listed at the top of this form. *
In submitting this form, the information provided above has been thoughtfully and honestly given, based on my knowledge and perception of the youth applicant. I understand that the information will be kept confidential and will be used by the CISV Pittsburgh chapter in the evaluation of the youth applicant. *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms