Delegation Application
Please apply here for your Witness For Peace Solidarity Collective Delegation.
Delegation you are applying for: *
Click "+ Add" and select delegation.
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Pronouns
(Optional)
- He/Him
- She/Her
- They/Them
- Other
(Please use two letter state abbreviation)
By applying, you give us permission to contact you via phone or text related to delegations or WFPSC programming, but you can request to not be contacted this way at any time.
Guardians' Contact
If you are under 18, please provide the names, phone numbers, and emails for two parents or guardians:
- {name}
(Optional)
(Optional)
What is your work/what do you dedicate your energy to? For how long? *
- {name}
Please share a brief bio to introduce you to fellow delegates: *
- {name}
How did you hear about this delegation? *
Please give more detail in the next question.
- Social Media
- Mailing
- Event
- Testimonial
- Search Engine
- Friend
- Organization
- Other
More Detail: *
Please share how you heard about the delegation, for example, who referred you, or at what event or from which organization you learned about it.
- {name}
Full Cost or Sliding Scale *
We offer a sliding scale rate for delegations. Are you able to pay the full cost, or will you submit a sliding scale application?
- Full Cost
- Sliding Scale Application
Spanish Language Ability
Select your ability to speak and understand Spanish:
- None
- Some
- Conversational
- Advanced
- Fluent
Physical Mobility *
Do you have any physical mobility-related needs? Please share any relevant illnesses, different abilities, disabilities, weaknesses, and/or mobility needs.
- {name}
Level of Health *
How is your health in general? Your answer will not necessarily prevent you from joining the delegation. Rather, this information will help us assess your needs, to take measures which would reduce the risk of serious health problems arising.
- Excellent
- Good
- Fair
- Poor
Allergies *
Do you have any food, environmental, or other allergies? What is the allergy, how do you react to the allergen, and what treatments do you use? (Please note: We ask you to please tell the WFPSC Team when you are on the ground about these allergies and that you remain your best advocate.)
- {name}
Doctor Care and Medication *
Please tell us any medication you take, its use, the dosage, and the name and contact information for your doctor, health, or medical practitioner.
- {name}
Dietary Concerns *
Please list any of your dietary needs or concerns. (Please note: vegetarian options are not standard but can be easier to organize. Vegan options are possible, but can be limited. We ask for your flexibility when it is difficult to accommodate dietary needs. Certain foods can be very difficult to access.)
- {name}
Is there any additional information regarding your mental, emotional, or physical well-being that you would like to share?
- {name}
Emergency Contact Name *
Please list an emergency contact's name, relationship to you, email, and phone numbers (home, cell, work).
- {name}
Personal Reference 1 *
Please provide a personal reference's name, relationship to you, email, phone number, and address.
- {name}
Personal Reference 2 *
Please provide a personal reference's name, relationship to you, email, phone number, and address.
- {name}
Please share some of your ideas for how you might share the information you will learn (about organizations on the frontlines and about the U.S. policies that impede their work), for when you return home *
For example - writing, coordinating an event, reporting back at a particular organization, policy-related advocacy, etc.
- {name}
Do you have any questions, feedback, or comments?
(Optional)
- {name}
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