Application for C.A.R.E. / Langara
Global Travel Award Volunteer Program
What is the C.A.R.E. / Langara Global Travel Award Volunteer Program?
The C.A.R.E. Langara Global Travel Award Volunteer Program is an opportunity that provides
airline travel, via Asia Miles travel points, for students who wish to engage in international
service learning and humanitarian assistance projects around the world. It is a program that is
dedicated to internationalization through the development of student leadership skills, civic
engagement and community based learning.
How the program works?
Successful applicants are provided with airline travel by the C.A.R.E. Society via Asia Miles air
travel points for round trip travel to countries that are served by Cathay Pacific Airways and its
affiliated partners. Use of the travel points will be subject to the availability of seats for the period
of travel. Applicants will be required to acknowledge the need to be flexible with travel dates in
order to make use of the awarded travel points and to confirm that any awarded travel points
will be used solely for travel to and from project locations. Layovers, except as required by flight
schedules, will not be permitted.
Who can apply?
In order to apply for the Travel Award Program applicants must:
• Be currently registered as a Langara College student (although travel does not need to take
place while attending Langara)
• Have attended an Information Session and/or have met with the Langara VOLT Coordinator
prior to applying
• Must commit to providing a post trip follow-up report as outlined in the application
Applications are reviewed and selected by the C.A.R.E. Society and Langara College. Students
are encouraged to apply as early as possible.
APPLICATIONS MUST BE SUBMITTED TO THE LANGARA VOLT COORDINATOR BY OCTOBER
31st, 2012
TERMS & CONDITIONS OF THE PROGRAM
• Flight bookings are subject to seat availability
• Travel support is for flights to countries that are served by Cathay Pacific Airways and its
affiliated partners only
• Travel support is provided by way of Asia Miles air travel points and does not include any
applicable fees, taxes, or surcharges involved in the cost of airline travel
• Incorrect or incomplete applications will not be considered
• Any changes to travel plans as submitted in at the time of application must be
communicated and approved by Langara College and C.A.R.E. immediately
• Strict adherence to College policies such as the College’s Code of Conduct (available on-line
at http://www.langara.bc.ca/about-langara/policies/index.html)
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 1 of 6
APPLICATION INFORMATION
Semester of Application:
□ SUMMER 2012 □ FALL 2012 □ SPRING 2013
Date of Submission: ______ / ______ / ________ (yyyy/mm/dd)
Have you previously applied for a C.A.R.E. Travel Award: □ Yes □ No
In addition to this completed application package have you attached the following documents?
□
□
Letter of acceptance from the agency / organization for which you are volunteering
□
/impact, c) your specific role in the initiative, and d) your personal goals and objectives
□
□
An 800 word project proposal outlining a) project purpose, b) expected outcomes
Resume (please indicate previous volunteer experience)
One letter of reference from a Langara representative or previous volunteer supervisor
Photocopy of your passport information page
Applicant Information
First Name: _____________________________
Middle Name(s): ____________________________
Gender:
□ Male □ Female
Last Name: _____________________________
Preferred Name: _______________________
Date of Birth: ______ / ______ / ________ (yyyy/mm/dd)
Citizenship: _____________________________
Educational Information
Student Number: _____________________________ Program of Study: _____________________________
Year of Study: _____________________________
Contact Information
Home Phone: _____________________________
Cell Phone: _____________________________
E-mail: _____________________________
Mailing Address (include City, Province, Postal Code, Country):
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 2 of 6
Emergency Contact Information
Primary Contact Name: _____________________________
Home Phone: _______________________________
Relationship: _____________________________
Cell Phone:
_____________________________
E-mail: ____________________________________________________________________________________________________
Secondary Contact Name: _____________________________ Relationship: _____________________________
Home Phone: __________________________________
Cell Phone: __________________________________
E-mail: ____________________________________________________________________________________________________
International Volunteer Information
Location of the Volunteering Experience: _______________________________________ (city/town, country)
Desired Date for Departure: ______ / ______ / ________ (yyyy/mm/dd)
Range of possible Dates for Departure: ______ / ______ / ________ to ______ / ______ / ________
Departure city: _____________________________
Desired date of return: ______ / ______ / ________ (yyyy/mm/dd)
Range of Possible Dates for Departure: ______ / ______ / ________ to ______ / ______ / ________
Departure City: _____________________________
Address abroad (include city, province, postal code, country):
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Organization / Agency Name: ____________________________________________________________________________
Supervisor(s) Name: _____________________________
E-mail: _____________________________________________
Phone: _______________________________
Website: _____________________________
Supervisor(s) mailing address (include city, province, postal Code, country):
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Please provide a brief description of the project and outline the key purpose of the initiative:
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 3 of 6
DECLARATION OF APPLICANT
I certify that all information within this application package is true and complete to my best
knowledge. I consent to the disclosure of information within this application package to Langara
College (the College), the C.A.R.E. Society (the Society), Asia Miles, and other parties involved in
this program.
I understand that failure to provide my consent, or any misrepresentation, may result in
cancellation of my application. As a condition of participation in the C.A.R.E. Langara Global
Travel Award Volunteer Program, I understand and agree to provide the College and the Society
with materials such as a written report and photographs as proof and record of my travel. I
hereby give the College, the Society, and Asia Miles the permission to utilize, publish, and release
any submitted materials for reporting, marketing or other purposes deemed appropriate by the
College, the Society, and Asia Miles.
I fully commit to providing a post trip follow up report as outlined in the application. (Please
refer to the Guideline for Post Trip Follow-Up Report on page 6 for more details.)
I hereby accept and agree to all the terms and conditions of the C.A.R.E. Global Travel Award
Volunteer Program as listed in this application package.
Applicant’s Signature: __________________________________
*Signature of Legal Guardian: ____________________________
Date: ______________________________
Date: ______________________________
*Full Name of Legal Guardian: ___________________________________ (*for applicants 18 years or younger)
DISCLAIMER
I understand that Langara College (the College) and the C.A.R.E. Society (the Society) are
providing no guarantees or representations regarding the quality and/or safety of my volunteer
experience. I understand that both the College and the Society expressly disclaim any
responsibility or liability for any loss, damage or injury that I may suffer in any way related to
the volunteer program that I have chosen.
I understand and assume sole responsibility and obligation for fully investigating the risks
associated with the volunteer organization, the location where I will be volunteering, and my
duties during the volunteer program, including all travel to and from the host country and
volunteer destination.
I further understand and assume sole responsibility and obligation for ensuring that I have the
appropriate travel documents, the medical approval of my physician to participate in this
volunteer experience, and that I have obtained necessary or recommended medical precautions
recommended to me by my physician.
Applicant’s Signature: __________________________________
*Signature of Legal Guardian: ____________________________
Date: ________________________________
Date: ________________________________
*Full Name of Legal Guardian: ___________________________________ (*for applicants 18 years or younger)
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 4 of 6
Global Travel Award Volunteer Program Waiver Form
I hereby waive, release, and discharge Langara College (the College), the members of its Board of
Governors, and anyone employed by or acting on behalf of the College from any and all claims,
causes of action, and any liability for personal injury, death, damage to property or loss of
whatsoever nature or kind and howsoever caused which I or my heirs, executors,
administrators, or anyone else may have arising out of or in any way related to my participation
in the Program, the volunteer experience, my presence in a host country, and any travel to or
from or within a host country.
____________
Initial*
I hereby waive, release and discharge the C.A.R.E. Society (the Society), and its governors,
directors, officers, agents, and employees from any and all claims, causes of action, and any
liability for personal injury, death damage to property or loss of whatsoever nature or kind, and
howsoever caused which I or my heirs, executors, administrators, or anyone else may have
arising out of or in any way related to my participation in the Program, the volunteer experience,
my presence in a host country, and any travel to or from or within a host country.
____________
Initial*
I understand that the Society and the College are not providing any guarantee related to the
volunteer program itself and that acceptance of this application does not provide any assurances
as to the safety or validity of the volunteer experience.
I hereby waive, release, and discharge the Society and the College from any responsibility
related to investigating the risks associated with the volunteer organization, location, and
experience.
I hereby waive, release, and discharge the Society and the College from any responsibility
related to my obligation for ensuring that I have the appropriate travel documents and obtain
any necessary or recommended medical precautions recommended to me by my physician.
I hereby accept and agree to all the terms and conditions of the C.A.R.E. Langara Global Travel
Award Volunteer Program as listed within this application package.
Applicant’s Signature: __________________________________
*Signature of Legal Guardian: ____________________________
*Full Name of Legal Guardian: ___________________________________
Date: ________________________________
Date: _________________________________
*Applicants 18 or younger at the time of application require the initial and signature of legal
guardian*
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 5 of 6
Guidelines for Post Trip Follow-Up Report
Upon return from your trip, we kindly ask you to share your experience with us and other
people who are interested in this program! Please prepare a written report and provide us with
some photographs taken during your trip. This report should be submitted via-email
(langaravolt@langara.bc.ca) or in the form of a CD or DVD to the VOLT Program Coordinator at
Langara College within a month of returning. This information will be submitted to the C.A.R.E.
Society.
The following questions are designed to give you some ideas of the type of information that you
can include in your report, but please feel free to include any additional information or materials
that you would like to share with us and other people who are interested in our program.
1.
What was the main purpose or reason of your travel?
3.
How has this experience affected you personally? What are the key results or
outcomes of your trip?
2.
4.
5.
6.
What did you do during your trip? Please describe in detail the various activities
that you did during your trip.
Did you benefit from this program? How did this program help you?
Would you recommend this program to other people?
Is there anything else that you would like to share with us? Please include any
additional comments and suggestions.
Successful applicants may be asked to present their report to members of the C.A.R.E. Society
and Langara College Community.
Please be informed that any collected materials may be used for reporting, marketing, or other
purposes deemed appropriate by Langara College and the C.A.R.E. Society.
* Please submit the completed and signed application package to the VOLT Office
c/o the VOLT Program Coordinator
Volunteer Program Office Use only
Date Application Received: _____________________________
Application Status: □ Accepted □ Rejected
Confirmation of Nomination to C.A.R.E. Society:
Program Coordinator's Signature: ________________________________
Program Manager’s Signature: ________________________________
Date: ___________________
Date: ___________________
C.A.R.E. Langara Global Travel Award Volunteer Program – Application Package (Created: August 2011)
Langara College, 100 West 49th Avenue, Vancouver, BC V5Y 2Z6
Page 6 of 6