SEVEC ONLINE APPLICATION FORM

SEVEC ONLINE APPLICATION FORM

Please note that as a result of the significant demand for exchanges, from all provinces and territories, not all applications to the program will result in an exchange. SEVEC tracks all of the groups' history and rotates the groups from each province and territory who receive funding each year, in order to ensure equal access to the program. The destination of each group's exchange is also tracked and rotated, as feasible, to ensure that groups are given the opportunity to visit different locations.

1. Group Identification

Type of group:

School-based

Community-based

Name of school/group

Street Address 1

Street Address 2 (Optional)

City

Prov./Terr.

Postal code

Telephone Number

Telephone Ext.

Fax Number

E-mail Address

Website Address

Group Organizer's Salutation

Dr. Sr. Mr. Mrs. Fr. M. Mme. Ms.

Group Organizer's First Name

Group Organizer's Last Name

Home Address 1

Home Address 2 (Optional)

City

Prov./Terr.

Postal code

Telephone Number (Home)

Telephone Ext.

Cellular Number

E-mail Address

If your group is a school group, what school board is it in?

Principal or Director's Salutation:

Dr. Sr. Mr. Mrs. Fr. M. Mme. Ms.

Name of Principal of school or Director or President of Association (must be different from Group Organizer)
First Name: Last Name:

Daytime telephone number where he/she can be reached:
Ext.

Principal E-mail Address:

In which official language do you wish to communicate? English French

2. Group Profile

NOTE:

If you have both male and female youth in your group, you must have at least one male and one female chaperone accompanying the group.
The subsidized chaperone ratio is
Groups of 10 or fewer youth: 1 chaperone
Groups of 11 to 20 youth: 2 chaperones
Groups of 21 to 30 youth: 3 chaperones

a) Estimated number of youth participants:

Females
Males
Female Chaperones
Male Chaperones

b) Can you be flexible in the size of your group?

No Yes

c) If yes. Please indicate:

MINIMUM number: MAXIMUM Number:

d) Age range of youth:

MINIMUM Age: MAXIMUM Age:

e) Can you be flexible in the age of the youth in your group?

No Yes

f) If yes, please indicate age range:

MINIMUM Age: MAXIMUM Age:

g) Grade level(s) of the participants

h) Maternal language of participants in the group:

English French

Other

i) Do you have previous experience in organizing an exchange?

No Yes

j) Are you applying to any other Exchanges Canada delivery organization at this time?

No Yes

If yes,

YMCA Canada Sports Friendship Exchange Programs

Canadian 4-H Council

Other

3. Group Description

a) Are you intending to take a pre-existing group (e.g. members of one grade 8 class, scout group, drama club, student council, sports team), or has your group been formed for the purpose of this exchange (e.g. 25 grade 9 students selected from 120)?

Pre-existing group Group formed for this exchange

b) If forming a group specifically for the purpose of taking part in this exchange, how are you selecting the participants?

c) We encourage the participation of youth who have traditionally been under-represented in exchanges. Please indicate if your group includes youth who fall within the following groupings: (please see Definitions on page 5 of the Guide)

	(i) Youth with disabilities?	No Yes
	A person with a long-term physical condition, mental condition, or health problem, who is limited with respect to functions in the home, in school or other activities (e.g. leisure time activities)	If yes, approximately how many total?
	(ii) Youth from low-income households?	No Yes
	A person who lives in a household earning less than the Low Income Cutoff as defined by Statistics Canada	If yes, approximately how many total?
	(iii) Aboriginal youth?	No Yes
	A member of a First Nation, a Métis or an Inuit	If yes, approximately how many total?
	(iv) Youth from rural or isolated areas?	No Yes
	A person who lives in a community with a population less than 10,000	If yes, approximately how many total?
	(v) Visible minority youth?	No Yes
	An individual, other than an Aboriginal person, who is non-Caucasian in race or non-white in colour	If yes, approximately how many total?

Other than regular transportation between your community and your twin community, do you expect to need any additional support to meet the needs of these participants (e.g. financial assistance for Low Income participants, sign language interpreter, modified vehicle, accessible home)?

Not sure No Yes

h) Are you in a rural community?

No Yes

If yes, what is the nearest major airport?
If yes, how far are you from there? kms

i) Special Travel Arrangements

4. Exchange Description

a) Please indicate the PRIMARY educational focus of your exchange (select only one):

	Official Languages & Cultures French Second Language - (FSL) English Second Language - (ESL) French Minority Language - (FL1) English Minority Language - (FLS) International Languages & Cultures Intra-cultural (e.g. Korean - Korean) Specify: Inter-cultural (e.g. Chinese - English) Specify: Aboriginal Languages & Cultures Intra-cultural (Inuit - Inuit) Inter-cultural (Ojibway - MicMac) Aboriginal - non-Aboriginal Regional Diversity - (Select a theme below) Band Choir Community Involvement Cultural Enrichment & Traditions Dance & Dramatic Arts Environment Geography History Leadership Science Sports Other (Specify: If a match is not found for the PRIMARY educational focus of your exchange, would you consider other possibilities? Yes No
b) Is there a secondary education focus/theme you wish to select for your exchange? (Optional - select only one):
	Band Choir Community Involvement Cultural Enrichment & Traditions Dance & Dramatic Arts Environment Geography History Leadership Science Sports Other (Specify)

c) Are you applying for a bilingual exchange? No Yes
You would like to be twinning with the following type of group:

             French Immersion
             Intensive French
             Intensive English
             Core or Basic French
             Core or Basic English
             Combo? Specify:

d) If it is not possible to match your group with another group wishing to do a bilingual exchange, would you like to be considered for an exchange with a group whose maternal language is the same as yours?
Yes No

e) Is your group an Official Minority Language (OML) group? (Francophones outside Quebec / Anglophones in Quebec)

No Yes

f) If yes, would you like to be twinned with another OML group?

No Yes

g) If yes, if another OML group wasn't available, would you consider a non-OML group?

No Yes

h) If you are not an OML group, are any participants in your group members of an Official Language Minority Group?

No Yes If yes, approximately how many?

The objectives for SEVEC Youth Exchanges Canada are:

To contribute to improved knowledge and understanding of Canada among Canadian youth;
To help young Canadians connect to one another and forge linkages throughout the country and among groups, thereby helping to strengthen the fabric of Canadian society;
To foster appreciation of both the diversity and the shared aspects of the Canadian experience.

Please check the activities that you are planning to include in your exchange program to achieve Exchanges Canada's objectives:

i) Before the exchange (Please check any that apply)

  Research home community
  Research twin community
  Develop joint project with twin group
  Encourage parents to communicate
  Encourage participants to communicate by e-mail
  Encourage participants to communicate by phone
  Encourage group correspondence
  Prepare introductory video
  Fundraising

ii) During the exchange (Please check any that apply)

  Develop group activities to encourage interaction among participants
  Work on a joint project
  Involve the community as a whole — potluck suppers, etc.
  Visit local attractions
  Schedule free time with families
  Document the exchange through videos, journals, photos, etc.

iii) After the exchange (Please check any that apply)

  Encourage participants to keep in touch by phone, letter or e-mail
  Inform the community about the exchange — presentations, media coverage
  Prepare scrapbooks and photo albums
  Prepare presentation and deliver it to local feeder schools, school board
  Develop project website

5. Specific Requests (Optional)

Please note: All groups applying to the program are considered individually for eligibility. Requesting a specific twin group does not change your group's eligibility. SEVEC must respect established provincial/territorial targets to ensure the equitable national distribution of the funds allocated to this exchange program. Requests for specific twinnings or locations are considered in light of these provincial and territorial targets and budget limitations once the eligibility of both groups has been determined. Exchanges between the West coast and the East coast are rare.

a) Do you wish to request a specific twin group?

b) If you wish to request a specific twin, please fill in the information below.
Both groups must apply separately to SEVEC, indicating that they wish to be twinned with each other.

Name of Twin School/Group Requested

Street Address

City

Prov./Terr.

Postal Code

Telephone Number

Fax Number

Twin Group Organizer's First Name

Twin Group Organizer's Last Name

Twin Group Organizer's E-mail Address

Twin Group Organizer's Telephone Number

Twin Group Organizer's Fax Number

c) If the specific twinning or location you have requested is not feasible for the reasons listed above, are you prepared to consider other possibilities?

Yes No

d) How did you hear about SEVEC?

e) Are you interested in a SEVEC Rendez-Vous Canada educational trip?

6. Exchange Period

Please indicate in which period you are hoping to do your exchange:

Summer 2010 School Year 2009-10 (Sept 2009 to June 2010)

Summer 2011 School Year 2010-11 (Sept 2010 to June 2011)

7. Agreement

I have read the accompanying guide and my group can comply with all of the criteria.

Yes No