The Game Changers: A Youth Training Against Human Trafficking August 15 to 16, 2015 / Tagaytay Highlands, Tagaytay, Philippines

ONLINE APPLICATION FORM

Please answer using Block Letters. Incomplete forms shall automatically be disqualified.

PART 1: PERSONAL INFORMATION Last Name: First Name: Middle Name: Nickname: Sex (Male or Female): Country of Residence: Area to be represented (choose one):  Luzon  National Capital Region  Visayas  Mindanao Address: Birthdate: Birthplace: Age: Mobile number: Mobile number: Telephone number: Nationality: Religion: Languages spoken: Dialects spoken: Special skills or talents: Hobbies and interests:

PART 2: ORGANIZATIONAL AFFILIATION Name of organization: Designation in the organization: Years in the organization: Address: Brief description: Name and designation of the head of the organization:

Telephone number: Fax number: Website: Email: PART 3: PARENTS AND EMERGENCY CONTACT Father’s Name: Occupation: Mother’s Name: Occupation: Emergency Contact Person: Relationship: Mobile number: Telephone number: Address:

PART 4: EDUCATIONAL BACKGROUND Name of School Years Attended Degree Received Elementary Secondary Tertiary Vocational Post Graduate Others

PART 5: ORGANIZATONAL AFFILIATION (Maximum of five relevant affiliations) Name of Organization Designation Years of membership Accomplishment

PART 6: Scholarship and Awards (Maximum of five recent scholarship/awards) Name of Scholarship/Award Awarding institution Year awarded

PART 7: Trainings or Conferences Attended (Maximum of ten relevant trainings) Name of Conference Organizing Institution Inclusive Dates

PART 8: Medical Condition, Food Restriction and Special Needs Allergies: Food Restrictions:

Special Medication: Do you have any disabilities? If yes, please specify.

PART 9: English Language Proficiency (Please put an X in the appropriate column) Excellent Very Good Good Fair Poor Speaking Reading Writing

PART 10: Additional Information Are you a World Youth Alliance member? If not, do you want to become a member?

Have you been a participant of previous programs organized by World Youth Alliance Asia Pacific and the Commission on Filipinos Overseas? If yes, what programs?

How did you know about The Game Changers? PART 11: Statement

I hereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my knowledge. I further declare any information given by me that is untrue may constitute a disqualification to the conference. The undersigned expressly authorizes World Youth Alliance Asia Pacific and the Commission on Filipinos Overseas or its representatives to use, share, and process my personal information I have provided, shared, or declared in this form for any lawful purposes. Further, I subscribe and agree that the World Youth Alliance Asia Pacific and Commission on Filipinos Overseas have the sole prerogative to select the participants to the training, and its decision is final and executory. IN WITNESS hereof, I am executing and signing this statement voluntarily without compulsion.

Name: Date:

PART 12: Essays A. Why do you want to join the training? (100 words or less)

B. What role can the youth play to help address problems related to human trafficking? (200 words or less)

C. What are your expectations from this training? In what way can you contribute to its success? (150 words or less) PART 13: World Youth Alliance Charter

The World Youth Alliance is composed of young women and men from every part of the world. In cooperation with other organs of the international community, primarily the United Nations and the European Union, the World Youth Alliance is committed to building D.free What and project just societies initiative through do you a want culture to implementof life. That when culture you affirms get back the to inalienable your school dignity or of communitythe person, to defends share solve the intrinsic the issue right of human to life, trafficking nurtures the in the family, Philippines? and fosters (200 a social words climate or less) favorable to integral development, solidarity, and mutual respect.

We recognize that the intrinsic dignity of the person is the foundation of every human right. We believe this dignity is independent of any individual condition and that no human community can grant or rescind that dignity.

We are convinced that the intrinsic dignity possessed by every human being from conception to natural death is the foundation of everyone’s right to life. We believe that this inalienable right to life is the basis of a free and just society and we believe that society through law and culture has an obligation to protect the dignity of the person and thus protect the right to life.

We affirm that the fundamental unit of human society is the family, where women and men learn to live in genuine freedom and solidarity, and where individuals are equipped to fulfill their social obligations. We believe that the political community at the local, national and international level is obliged to protect and nurture the family.

We believe that the authentic development of society can occur only in a culture that fosters integral human development – characterized by physical, spiritual, mental, and emotional growth, in a climate of respect for the human person and the family.

We invite all those who share these convictions to join us in affirming them and giving them effect in public life at all levels.

Do you want to become a WYA Member?

 Yes, I would like to be a WYA Member.  No, I wouldn’t like to be a WYA Member.  No, I’m already a WYA Member.

Please send your completed application forms to [email protected]. For inquiries, you may call the organizers through phone +63.2.9215162. You may also visit our website at www.wya.net/thegamechangers or send us an email.

Deadline of application is on July 12, 2015 (Sunday).

Thank you for applying!