DOWNLOADABLE PDF VERSION OF APPLICATION:

*Please submit PDF application via email to YPL2019@culturalvistas.org

2019 Young Pacific Leaders Conference - FIJI

2019 YPL Program:

Virtual Activities - February 2019

YPL Conference in Fiji - 1st Week of March 2019

YPL LEADS Activities - May 2019

Application Deadline 12:00 AM: (New Zealand Time), 2 December 2018

(We anticipate that participants will be selected by 21 December 2018)

All required fields in this application must be answered completely.

Eligibility

Applicants must meet ALL of the following criteria to be eligible for the program:

1. Applicants must be 25-35 years old at time of the conference

2. Applicants must be a citizen and current resident of one of the YPL countries: Australia, the Cook Islands, Fiji, the Federated States of Micronesia, the Islands of French Polynesia, Kiribati, the Marshall Islands, Nauru, New Caledonia, New Zealand, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu, Wallis and Futuna, and the American-affiliated Pacific including American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and Hawaii.

3. Applicants must be fluent in English. The YPL Conference will be held entirely in English.

4. Applicants must have a minimum of two-years work experience.

5. Applicants must be able to travel to Fiji and attend the 2019 YPL conference in its entirety. The YPL Program will cover all travel, accommodation and meals for selected recipients.

*Please note travel dates may vary based on location of departure and may require extended layovers depending on flight itineraries. Please contact Cultural Vistas for more information at YPL2019@culturalvistas.org.

Application Directions

1. Prepare electronic versions of the following items; you will upload them at the end of this application:

- Current C.V. or Resume (Limit 2 pages, Word Document or PDF format)

- Passport: Accepted participants must have a passport valid through 1 November 2019 at the time of the workshop. A copy of the biographic page is required (page with picture, legal name, birth information) and can be uploaded towards the end of the online application.

2. Complete this form in entirety including the two essay questions.

3. Upload the required documents

4. Review and agree to program terms and conditions

5. Submit

**Please note that once started, the application is only saved upon full submission. Should you wish to print a copy of your application, please do so prior to submitting. It is recommended that applicants have all required documents (resumes, written materials, etc.) ready and in Word Document or PDF formats prior to begining the application. No other format types are supported and any materials submitted in other formats will not be accepted, deeming the application incomplete. Incomplete applications will not be processed.

Personal Information

AS APPEARS ON PASSPORT (*Information below must match your valid passport or other government-issued ID*)

Surname (Family name) *

Given Names *

Does your passport expire AFTER 1 November 2019? *

Yes

No

Date Passport Expires (DD/MM/YYYY) * +

Biographical Information

Gender *

Date of Birth
Day, Month, Year (Example:1 June 1995) *

City/Town of Birth *

State/Province of Birth

Country of Birth

Country of Citizenship? *

What is your native language?

Do you have any dietary restrictions? *

No

Yes (Please list) Yes (Please list)

Do you have any physical conditions or allergies about which we need to be aware to prepare for your participation in this program? *

No

Yes (Please list) Yes (Please list)

Have you ever participated in a U.S. government-sponsored program? *

No

Yes (Please indicate program; for example, Fulbright, IVLP, U.S. Embassy Program, etc.) Yes (Please indicate program; for example, Fulbright, IVLP, U.S. Embassy Program, etc.)

Current Contact Address

PLEASE NOTE, the YPL Program will only arrange participant travel from YPL-eligible countries to the Conference. If you currently reside outside of the region, you will be responsible for arranging your own travel to a YPL country for Conference travel to Fiji.

Street Address *

Street Address #2 (If applicable)

City/Town *

Country *

Postal Code

Primary Telephone
(Include country code) *

Other Telephone
(Include country code)

E-mail Address *

Re-type E-mail Address *

Facebook Account: (Please indicate N/A if you do not have an account) *

Twitter Account: (Please indicate N/A if you do not have an account) *

Instagram Account: (Please indicate N/A if you do not have an account) *

Home Address (if different from current address)

Street Address

Street Address #2 (If applicable)

City/Town

Country

Postal Code

Professional Experience

Paid work experience, including full time or part time employment, or paid internship:

Current or Most Recent Employer Name *

Dates of Employment (Format MM/YY) *

City *

Country *

Website

Position Title *

Do you use English in your professional or academic settings? *

No

Yes (Please describe) Yes (Please describe)

Unpaid internship or volunteer experience:

Host Company or Organization

When did you work or volunteer?

Briefly describe your position/involvement:

Please list any additional information about activities, organizations, or jobs you would like to share that is not evident from your CV:

International Experience

Do you have any previous experience working or studying in another country (besides your home country)? *

No

Yes (If yes, please describe) Yes (If yes, please describe)

Please indicate the areas you have visited:
*

If you have traveled outside of your home country, indicate the purpose of travel:

Previous Association with YPL

Have you previously participated in a Young Pacific Leaders Conference or Program? *

No

Yes (If yes, please describe when/where) Yes (If yes, please describe when/where)

If you are applying to serve as an Alumni Mentor, please describe your interest in serving as a mentor to new YPL participants:

0/500 words

How did you find out about this opportunity?

How did you find out about the 2019 YPL Conference? *

If you selected "OTHER", please explain:

Emergency Contact Information

Please give the name and contact information of a spouse, relative and/or close friend which Cultural Vistas can contact in case of an emergency in which we cannot reach you.

Title *

Surname (Family Name) *

Given Name(s) *

Relationship to You *

Street Address *

Street Address #2 (If applicable)

City/Town *

Country *

Postal Code

Primary Telephone
(Include country code) *

Secondary Telephone
(Include country code) *

E-mail address *

Re-type E-mail address

Essay Questions

In 1000 words or less, please describe your interest in the Young Pacific Leaders Program and how you will use the information and networks you develop through the program to improve your community, country or region. Please include your own ideas for collaboration and long-term engagement with the Young Pacific Leaders Program. *

0/1000 words

In 1000 words or less, please describe in your own words what leadership means to you, and how you have served as a leader in your community, workplace, or country. *

0/1000 words

Supporting Documents

Please upload the following documents:

C.V./RESUME (Limit 2 pages, Word Document or PDF Format) *

PASSPORT - Copy of the current biographic page of your valid passport (page with picture, legal name, birth information). *

Program Terms and Conditions

Read and check each statement below to indicate agreement:

I hereby agree to the following terms and conditions:
*

I certify that I will comply with all laws, regulations and/or restrictions of appropriate government agencies (including the U.S. Department of State and Government of Fiji), and will comply with Cultural Vistas' participant Code of Conduct upon my selection into this program.

I understand that this program will cover the cost of travel to Fiji for the 2019 YPL Conference. In addition, I understand (shared) lodging will be covered as well as program meals.

I release Cultural Vistas and the U.S. Department of State to use any photographs and written statements for program promotion, published advertising and other marketing purposes and hereby consent the use of my submission in any promotional material produced and/or published by Cultural Vistas in relation to the 2019 YPL Conference and subsequent program activities.

I certify that the information given in this form is complete and true and that if selected to participate in the program, I will fulfill my obligations and responsibilities associated with the 2019 YPL Conference, preceding and subsequent conference activities, and other YPL Program initiatives.

If you have any questions about these program conditions, program details, or need assistance submitting an application, please contact Cultural Vistas at YPL2019@culturalvistas.org.

Application Deadline 12:00AM (New Zealand Time), 2 December, 2018

Africa	Asia
Europe	Middle East
North America	South America
Other Pacific (not your country)	Not applicable

Study	Visit family members
Leisure/tourism	Volunteer activity
Work experience	Other: Other: