YOUTH APPLICATION
Guatemala June 2016

As part of the YEWTHS ROC program capstone, youth are invited to experience the fruits of their labor by participating in an expedition to distribute the wheelchairs they have sponsored and built.

Who Can Go? Students in grade 8 - college level are welcome to apply. A limited number of spaces are available.
Where Are We Going? Hope Haven, Sacatepéquez, Guatemala
How Much Does it Cost? Estimated cost is $2000 (includes transportation, food, lodging, and activities). Spending money is additional. Participants are responsible for raising their own financial support for the trip.
How Do I Apply? Fill out the required form below and send in the additional required information (outlined below) to ROC Wheels, P.O. Box 11765, Bozeman, MT 59719

Checklist for Application: 17 Years and Younger

Required Items:

  • Youth Volunteer Application Form (See Below): Due February 1st
  • Essay or resume with required elements (Email to info@rocwheels.org or Mail to ROC Wheels P.O. Box): Due February 1st
    • Please include the following information in your essay or resume:
      • What you hope to offer the ROC Team and the children affected by disabilities and their families (ex. your talents/gifts/traits/etc.)
      • Your reasons for applying to be a ROC Youth Volunteer
      • Volunteer history with ROC Wheels
      • Volunteer and extracurricular activities
      • Work experience
      • Your strengths and weaknesses
      • Name and age
  • Teacher or Academic Mentor Letter of Recommendation (Email to info@rocwheels.org or Mail to ROC Wheels P.O. Box): Due February 1st
    • Please inform the professional writing the recommendation that they are writing a letter of recommendation for the purpose of applying for the ROC Wheels Guatemala Distribution. Provide them ROC Wheels email address or mailing address so that the letters can be sent directly to ROC Wheels.
  • Pastor or Employer Letter of Recommendation (Email to infor@rocwheels.org or Mail to ROC Wheels P.O. Box): Due February 1st
    • Please inform the professional writing the recommendation that they are writing a letter of recommendation for the purpose of applying for the ROC Wheels Guatemala Distribution. Provide them ROC Wheels email address or mailing address so that the letters can be sent directly to ROC Wheels.

Trip Fees: All checks should be made out to ROC Wheels Inc.

  • Trip Fees: All checks should be made out to ROC Wheels Inc.
    • $1000 Deposit (Due by February 1st) - Mail to ROC Wheels
    • Balance of Funds ($1000) due by May 1st- Mail to ROC Wheel 

Other Requirements Due After Application Approval:

  • Obtain Passport- Email scanned copy of passport to info@rocwheels by April 15th
    • Note: If you don't have a passport, you should apply for one no later than January 15th.
  • Personal Covenant and Liability Release Form (Mail to ROC Wheels P.O. Box) - Due April 15th
  • Parental Consent Forms (Mail to ROC Wheels P.O. Box) - Due April 15th
  • Obtain Vaccinations- Contact the County Health nurse for current vaccination requirements

If you are 18 years or older, do NOT fill out this application! Please fill out the Adult Application

Youth Volunteer Application Form

In addition to filling out this form, you will need to also send in the required information outline above (ie. Essay, Letters of Recommendation, Application Fee). If you have any questions regarding the form please email us at info@rocwheels.org.

Personal Information
Date of Application *
Date of Application
Name *
Name
Please include your middle name as well, if applicable.
Ie. John and Judy Smith
Parent Phone *
Parent Phone
Home Address *
Home Address
Personal Phone *
Personal Phone
Best Method of Contact *
Please provide your passport number or if you do not currently have one, enter the number 0. Keep in mind that you should apply for a passport by December 5th.
Date of Birth *
Date of Birth
Gender *
Medical Information
Emergency Contact
Name of Emergency Contact *
Name of Emergency Contact
Phone of Emergency Contact *
Phone of Emergency Contact
References
Please give the following information for the individuals that will be writing your letters of recommendation. For more information, see above.
Name of Teacher or Academic Mentor *
Name of Teacher or Academic Mentor
Address of School/Program *
Address of School/Program
Phone Number for Teacher or Academic Mentor *
Phone Number for Teacher or Academic Mentor
Name of Pastor or Employer *
Name of Pastor or Employer
Address of Church or Employer *
Address of Church or Employer
Phone Number for Pastor or Employer *
Phone Number for Pastor or Employer
Signature
Electronic Signature *
Electronic Signature
By confirming your name here, you are confirming that the above information is correct to the best of your knowledge. Any changes to the information above should be notified to ROC Wheels Inc.
Today's Date *
Today's Date