Witness for Peace Delegation Application

Select your delegation name from the drop down menu (click on arrows and scroll down to find). *

Delegation Dates *
Delegation Coordinator Name *
Name on Passport *
Passport Number *
Passport Expiration Date *
Passport Country of Issue *
Date of Birth *
If you are under 18, please provide the names and contact (phone & email) for both your parents or guardians. *
Gender Identity *
Birthplace *
Occupation / Number of Years *

How Did You Hear About This Delegation *

Friend / Other
We are offering sliding scale rates for delegations. Are you able to pay in full? * I am able to pay for the delegation in full. I will be filling out a sliding scale application.
Do you have any physical weaknesses, different abilities or illnesses that could impact your mobility or health on this delegation? *
How is your general health? Negative answers to the following questions will not necessarily prevent you from being invited to travel with WFP. This information will help us in assessing your needs and allow us to take measures which would reduce the risks of serious health matters during the course of the trip. Providing false information will result in dismissal from the program and Witness for Peace is not responsible for health issues that may occur during the course of the trip. * Excellent Good Fair Poor
Do you have any food, environmental or other allergies? *
Doctor Care and Medication *
List any dietary concerns. (Please note that while there will usually be vegetarian options, vegan options are very difficult. Flexibility is necessary as it may be difficult to accommodate rigid dietary needs in areas where foods are difficult to get and local customs differ.) *
Are there any mental or emotional health concerns you would like to share? *

Spanish *

Emergency Contact *
Please provide two personal references. Reference 1 *
Reference 2 *
Do You Have Experience With Human Rights, Social Justice, Environmental, Or Other Organizations That Are Committed To Social Change? If So, Please Describe.: *
How Did You Hear About WFPSC And Why Would You Like To Participate In The Delegation Travel Program? *
Why Do You Want To Travel With This Particular Delegation? *
Are You Willing To Adhere To A WFPSC Policy Of Non Violence During This Delegation? *
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Please apply here for your Witness For Peace Solidarity Collective Delegation.