Please cut and paste this application into a Word Document and submit it electronically as an attachment (along with your resume) to applications@chiapaspeacehouse.org

A.  Basic Information:
Name
Address
City
State, Zip
Phone
Email
 
B.  Additional Background Information
Permanent Address
City, State, Zip
Phone
Date of Birth
Birthplace (City, Country)
Occupation
Marital Status, number of kids
How did you hear about Chiapas Peace House Project?
 
C.  Heath and Emergency Information
The Chiapas Peace House Project does not discriminate on the basis of race, religion, sexuality, gender, age or physical ability.  However, applicants should be aware that Chiapas is not wheelchair friendly, stomach sickness caused by parasites and viruses is common and medical facilities may not be what you’re used to.  Please answer these questions honestly as they may present challenges to your work that we will need to discuss and accommodate.   
1. Do you have any physical weaknesses, allergies, disabilities, illnesses, dietary constraints? 
2. Do you take any regular medications?
3. Do you have any history of drug or alcohol abuse?
4. Have you been hospitalized for an emotional or mental illness in the last year?
 
D. Spanish
What is your level of Spanish in reading, writing, comprehension, verbal expression?  How did you become proficient?  Be prepared for phone interview in Spanish. 
 
E.  Two references
 
F.  Resume (educational, professional, volunteer and social justice experience)
 
G. Short Answer Essays (Please keep answers between 2 paragraphs and 2 pages)
 
1. Please briefly comment on your interest in or experience working in the following areas (Note that the Development Internship will include these aspects, but having previous experience in all fields  is not a requirement. We are trying to get an assessment of your experience as well as your interests and potential) :
·       Analytical writing, editing, coordinating newsletter production
·       Counseling, teaching, conflict resolution
·       Communal living, group consensus process
•       International solidarity work
·       Translating, research, creating educational materials, computer literacy
·       Networking, coordinating delegations, grant writing, fundraising, community organizing
·       Other skills or experiences you would like to mention
 
2. What are your strengths and talents, your challenges and weaknesses?  Highlight experience working in cross-cultural, multicultural settings, in rural “underdeveloped” conditions, experience living abroad and in working in social justice fields.
 
3. Why are you interested in this internship?  Please discuss your motivations, what do you hope to gain and to contribute.