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Text Box: HOME				PO Box 145 - Scottdale, Georgia  30079		Email:atlanta@cisvusa.org

Forms

If you need an alternative, forms can be accessed at the new CISV USA Forms webpage or the old CISV USA Forms webpage.

 

Leadership Forms

 

Junior Counselor Application

(must be age 16 or 17 sometime between Jun 1 & Aug 31 of program year)

· Chapter Membership (must be CISV Atlanta Family Members to apply / $50)

· Leadership Application (4 pages)

· Supplement for Junior Counselor Applicants (please attach a snapshot)

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

 

Junior Counselor Health & Legal Forms

· Chapter Family Membership (must be CISV Atlanta Family Members 2 years past program year / $100)

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· TWAL Form (needs notary signature)

· Parental Release Form (needs notary signature / JC needs both Release Forms)

· Participant Release Form (needs notary signature / JC needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Interchange Junior Leader Application

(must be age 19 or 20 sometime between Jun 1 & Aug 31 of program year)

· Chapter Family Membership (must be CISV Atlanta Family Members to apply / $50)

· Leadership Application (4 pages)

· Supplement for Interchange Junior Leader Applicants (please attach a snapshot)

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

 

Interchange Junior Leader Health & Legal Forms

· Chapter Family Membership (must be CISV Atlanta Family Members 2 years past program year / $100)

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· TWAL Form (needs notary signature)

· Parental Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Participant Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Village Adult Leader Application

(must be age 21 or older at time of program travel)

· Chapter Membership (must be CISV Atlanta Member to apply / $30 Individual or $50 Family)

· Leadership Application (4 pages)

· Supplement for Village Adult Leader Applicants (please attach a snapshot)

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

· Driving History Report (MVR) (for last 3 years / must be age 25 or older to drive CISV participants)

· Anyone driving others for the purposes of a CISV program must supply Chapter his/her current personal auto policy with liability coverage of at least $100,000

 

Village Adult Leader Health & Legal Forms

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· ALIF Form (needs notary signature)

· Participant Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Summer Camp Adult Leader Application

(must be age 21 or older at time of program travel)

· Chapter Membership (must be CISV Atlanta Member to apply / $30 Individual or $50 Family)

· Leadership Application (4 pages)

· Supplement for Summer Camp Adult Leader Applicants (please attach a snapshot)

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

· Driving History Report (MVR) (for last 3 years / must be age 25 or older to drive CISV participants)

· Anyone driving others for the purposes of a CISV program must supply Chapter his/her current personal auto policy with liability coverage of at least $100,000

 

Summer Camp Adult Leader Health & Legal Forms

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· ALIF Form (needs notary signature)

· Participant Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Interchange Adult Leader Application

(must be age 25 or older by program start date)

· Chapter Membership (must be CISV Atlanta Member to apply / $30 Individual or $50 Family)

· Leadership Application (4 pages)

· Supplement for Interchange Adult Leader Applicants p.1 | p.2 (please attach a snapshot)

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

· Driving History Report (MVR) (for last 3 years / must be age 25 or older to drive CISV participants)

· Anyone driving others for the purposes of a CISV program must supply Chapter his/her current personal auto policy with liability coverage of at least $100,000

 

Interchange Adult Leader Health & Legal Forms

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· ALIF Form (needs notary signature)

· Participant Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Staff Application

(must be age 21 or older by program start date / at least one staff member at each program must be age 25 by program start date)

· Chapter Membership (need to be a CISV Chapter Member to apply / $30 Individual or $50 Family)

· Leadership Application (4 pages)

· Supplement for Staff Applicants: p.1 | p.2

· Confidential Reference Form for CISV Leadership / Staff Position (need 3 references)

· Consent for Background Check | pdf (needs notary signature / must be redone every 3 years)

· Driving History Report (MVR) (for last 3 years / must be age 25 or older to drive CISV participants)

· Anyone driving others for the purposes of a CISV program must supply Chapter his/her current personal auto policy with liability coverage of at least $100,000

 

Staff Health & Legal Forms

· Health Form (needs doctor’s signature / set physical within 90 days of departure date)

· ALIF Form (needs notary signature)

· Participant Release Form (needs notary signature / Junior Leader needs both Release Forms)

· Child & Adult Internet Communications Release Form

· National Code of Conduct Agreement

 

Youth Delegate Forms

If you need an alternative, forms can be accessed at the new CISV USA Forms webpage or the old CISV USA Forms webpage.