Odawara Student/Young Professional Ambassador Program Application

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Please be advised that Information provided in this application is unable to be saved to come back to at a later time.  If you are unable to complete the application in its entirety , you may want to consider saving (questions and/or answers) in a separate document (e.g a word document) and complete this application when you are able to complete and submit in its entirety.

 Deadline to submit is 5:00 p.m. on March 11, 2019

Odawara, Japan is one of Chula Vista's Sister Cities.  A Sister City is an officially approved, long-term partnership, that has the potential to carry out diverse activities and cultural exchange, primarily involving three sectors, local government, business, and citizen volunteerism. 

2019 Program Information

Program in Odawara: Depart Thursday August 1, 2019  through Tuesday  August 13th, 2019.

Program in Chula Vista from Tuesday August 13, 2019 through Friday August 23th, 2019.

Selected Ambassadors MUST be able to participate for the entire duration of the exchange program.

 Application is due NO LATER than 5:00PM on Monday, March 11 , 2019. INCOMPLETE APPLICATIONS MAY NOT BE CONSIDERED.

Candidate interviews will be held on Wednesday, March 20, 2019 6pm - 8pm. Selected applicants will be contacted with their scheduled interview time. Note: up to four (4) Chula Vista Ambassadors will be appointed.  Up to $1,000 travel stipend for airfare will be awarded to each of the 4 appointed Ambassadors to be reimbursed after travel*.

For questions or more information please contact:  Lynnette Tessitore; Cultural Arts Manager at   ltessitore@chulavistaca.gov

or Phone: (619) 409-5465.

*Documentation that includes traveler, flight information, and payment is required for reimbursement.

Student/ Young Professional Ambassador Program ( SECTION I)

Up to four (4) Chula Vista students or young professionals (ages 18-23) will be selected by the City's International Friendship Commission to represent the City of Chula Vista for a month long exchange program with Ambassadors from Odawara (ages 18-28) .

Odawara, Japan Program

While in Odawara, the four Chula Vista Ambassadors will represent the City of Chula Vista at events and functions including, but not limited to: volunteering at local nonprofits/charities, business functions/dinners, attending Odawara City Council meetings, local excursions, etc.  Odawara Ambassadors and/or host families will arrange local transportation and accompany Chula Vista Ambassadors while they are in Odawara.  Chula Vista Ambassadors are not permitted to drive during their visit in Japan.

 Chula Vista, California Program

While in Chula Vista, the four Odawara Ambassadors will be representing Odawara, Japan at events/functions including, but not limited to: volunteering at local nonprofits/charities, business functions/dinners, attending Chula Vista City Council meetings, local excursions, etc. Chula Vista Ambassadors and/or host families will arrange  all local transportation and accompany Odawara Ambassadors while they are in Chula Vista.  Odawara Ambassadors are not permitted to drive during their visit in the United States.

Ambassador Program Requirements: (All documentation must be uploaded)

  • Must be between the age of 18 and 23 and possess a valid USA passport or be a USA permanent resident with a valid International passport (copy required)
  • Must be a resident of Chula Vista (evidence required)
  • Must be currently enrolled in college, college bound, or employed (transcripts or evidence of employment required)
  • If selected, all Ambassadors must submit a post-travel community or study project.  All projects must be approved, in advance, by the International Friendship Commission. To be submitted to and presented to the International Friendship Commission within 30 days of end of 2019 Program.
  • Two references (known for more than one year):
    • From an academic source or past/current employer
    • Community/Civic/Cultural Organization
  • Doctor’s clearance (written statement or physical form) verifying that candidate is fit for international travel.
  • It is expected that selected Chula Vista Ambassador families will host Odawara Ambassadors while they are in Chula Vista. All efforts will be made to match Ambassadors by similar age (within a few years) and by  gender.
  • Essay (400 words max) or in digital form not to exceed three minutes explaining why applicant would like to participate in the Odawara Ambassador Program
  • Signed Program Waiver/Consent/Release form
  • Health Insurance that provides for health care abroad and health emergency return travel (evidence required)

 Host Family ( SECTION II)

The host family is a vital part of the Odawara Student/Young Professional Ambassador Program.  Serving as a Host Family comes with great responsibility to care and nurture  the visiting Ambassador as one would a member of their family.  The visiting Ambassador would live in your home and share in your everyday lives.  The Host Family Guidelines are listed below.  If selected to be a Host Family, you and your family agree to treat the Odawara, Ambassador with respect, to ensure that the Ambassador is healthy and safe,  and to provide an appropriate level of parental supervision.  Two (non-relative) references are required.

Host Family Guidelines

  • Share your culture with the Ambassador(s)
  • Provide a positive impression of Chula Vista
  • Attend the Ambassador Welcome Dinner (dates TBD)
  • Attend the Ambassador Farewell Dinner (dates TBD)
  • Provide accommodations as stated in your application
  • Ensure the safety of Ambassador(s)
  • Provide transportation or coordinate transportation for the Ambassador to and from airport and to all planned activities/events
  • Participate with the Ambassador in as many of the scheduled activities/events, as possible
  • Coordinate activities with the Ambassador on FREE days, with other Host Families if possible
  • Have fun and feel free to ask questions.
  • Do NOT travel with the Ambassador beyond San Diego County limits (no exceptions)
  • Host Family members or Ambassador shall NOT use illegal drugs or participate in other illegal activities.

SECTION I:  STUDENT/YOUNG PROFESSIONAL AMBASSADOR
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Applicant Information

 

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Applicant Information
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Applicant's Physical Address
Applicant's Physical Address
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Email Address
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Primary Language
Primary Language
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Emergency Contact Information
Emergency Contact Information
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For Student Applicants Only
For Student Applicants Only
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Young Professional Applicants Only
Young Professional Applicants Only
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Ambassador References- Please list TWO non-relative references (academic or professional) and upload letters of recommendations from these references at the end of SECTION I.

Reference #1


Ambassador References- Please list TWO non-relative references (academic or professional) and upload letters of recommendations from these references at the end of SECTION I. Reference #1
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Ambassador References

Reference #2


Ambassador References Reference #2
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Health Information (A)
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Health Information (B)
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Health Information (C)
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STUDENT/YOUNG PROFESSIONAL  ACCEPTANCE OF PROGRAM TERMS

By checking the box below you certify that the information contained in this application, including all attachments and supporting materials, is true and correct and that you understand and agree to all of the following terms and conditions:

a.  I am a resident of Chula Vista, CA.

b.  I am a college bound student or attending college and/or employed.

c.   I have a valid U.S.A. passport or a USA permanent resident with a valid International passport.

d.  I will be between the ages of 18 and 23 on the date of departure to Odawara, Japan.

e. If selected, I will be responsible for my own personal expenses, in addition to the $1,000 travel stipend provided by the City of Chula Vista.

f.   I will provide two signed Program Waiver/Consent/Release forms (to be submitted at time of interview)

g.  I have my own medical insurance, including international health care insurance that provides for health care while abroad and emergency health travel coverage.  I agree I am responsible for my own health maintenance care.

h.  I will provide my own medical inoculations as recommended and required by the Department of Public Health and own Physician.

i.    I will prepare and provide a full report to the Chula Vista Mayor and Council on the Odawara  Exchange Program.

j.   The Chula Vista program will include at least one community service project.

k.   If for any reason, any action or conduct is deemed inappropriate by the City of Chula Vista’s International Friendship Commission or Odawara, the Ambassador will be removed immediately from the Odawara Ambassador Program and the Ambassador will be fully responsible to refund the City of Chula Vista the entire $1,000 travel stipend. within 30 days of dismissal. Further, you agree to obey all laws, including U.S. and Japanese laws.  You understand that you waive any rights, remedies, causes of action or claims involving my dismissal from the program.

l.    As part of our procedure for processing your application, your personal and employment references will be checked, including a background check. If you have misrepresented or omitted any facts on this application, and are subsequently selected, you may be discharged from this program. You may make a written request for information derived from the checking of your references.  By your signature below, you waive any and all causes of action or claims involving the aforementioned background check and agree to such background check.

m. In such  case of an emergency or if you are unable to be reached, you authorize U.S. embassies and consulates to release information concerning your  welfare and whereabouts to the City of Chula Vista, including the City Manager or his/her designee.  In authorizing this release of information, you hereby waive 5 U.S.C. Section 522(b)(8).

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STUDENT/YOUNG PROFESSIONAL ACCEPTANCE OF PROGRAM TERMS By checking the box below you certify that the information contained in this application, including all attachments and supporting materials, is true and correct and that you understand and agree to all of the following terms and conditions: a. I am a resident of Chula Vista, CA. b. I am a college bound student or attending college and/or employed. c. I have a valid U.S.A. passport or a USA permanent resident with a valid International passport. d. I will be between the ages of 18 and 23 on the date of departure to Odawara, Japan. e. If selected, I will be responsible for my own personal expenses, in addition to the $1,000 travel stipend provided by the City of Chula Vista. f. I will provide two signed Program Waiver/Consent/Release forms (to be submitted at time of interview) g. I have my own medical insurance, including international health care insurance that provides for health care while abroad and emergency health travel coverage. I agree I am responsible for my own health maintenance care. h. I will provide my own medical inoculations as recommended and required by the Department of Public Health and own Physician. i. I will prepare and provide a full report to the Chula Vista Mayor and Council on the Odawara Exchange Program. j. The Chula Vista program will include at least one community service project. k. If for any reason, any action or conduct is deemed inappropriate by the City of Chula Vista’s International Friendship Commission or Odawara, the Ambassador will be removed immediately from the Odawara Ambassador Program and the Ambassador will be fully responsible to refund the City of Chula Vista the entire $1,000 travel stipend. within 30 days of dismissal. Further, you agree to obey all laws, including U.S. and Japanese laws. You understand that you waive any rights, remedies, causes of action or claims involving my dismissal from the program. l. As part of our procedure for processing your application, your personal and employment references will be checked, including a background check. If you have misrepresented or omitted any facts on this application, and are subsequently selected, you may be discharged from this program. You may make a written request for information derived from the checking of your references. By your signature below, you waive any and all causes of action or claims involving the aforementioned background check and agree to such background check. m. In such case of an emergency or if you are unable to be reached, you authorize U.S. embassies and consulates to release information concerning your welfare and whereabouts to the City of Chula Vista, including the City Manager or his/her designee. In authorizing this release of information, you hereby waive 5 U.S.C. Section 522(b)(8).
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Student/Young Professional Additional submittal requirements : Upload all of the following:

 

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Student/Young Professional Additional submittal requirements : Upload all of the following:
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Would you consider being an Ambassador Lead?  A Lead is the liaison to the IFC and fellow Ambassadors.  The Lead will also be the point person of the group’s culminating presentation(s) to the IFC, OIFA, and the City Council.
Would you consider being an Ambassador Lead? A Lead is the liaison to the IFC and fellow Ambassadors. The Lead will also be the point person of the group’s culminating presentation(s) to the IFC, OIFA, and the City Council.
SECTION II : HOST FAMILY
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How did you hear of the Odawara, Japan Ambassador Program?  If your family member is not participating as an Ambassador, please also explain why you would like to volunteer to host an Ambassador in your home. 

 


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Would you consider hosting more than 1 Ambassador?
Would you consider hosting more than 1 Ambassador?
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It is expected that the family of selected Ambassadors will host Odawara Ambassadors while here in Chula Vista.  Will you be hosting an Odawara Ambassador?  If no, please explain.
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It is expected that the family of selected Ambassadors will host Odawara Ambassadors while here in Chula Vista. Will you be hosting an Odawara Ambassador? If no, please explain.
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Have you previously hosted a student exchange student or sister cities ambassador?  If yes, please explain.
Have you previously hosted a student exchange student or sister cities ambassador? If yes, please explain.
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Would you consider sponsoring or hosting either the Ambassador Welcome Dinner or the Ambassador Farewell Dinner?
Would you consider sponsoring or hosting either the Ambassador Welcome Dinner or the Ambassador Farewell Dinner?
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HOST FAMILY - Answers provided in this section will be provided to the Cultural Affairs Department in Odawara, Japan and will be shared with the proposed Odawara Ambassador.
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HOST FAMILY - Answers provided in this section will be provided to the Cultural Affairs Department in Odawara, Japan and will be shared with the proposed Odawara Ambassador.
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HOST FAMILY - Parent #2
HOST FAMILY - Parent #2
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Host Parent #1 Email Address
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Host Parent #2 Email Address
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Host Family Personal References- Please list TWO non-relative references (personal or professional).

Reference #1


Host Family Personal References- Please list TWO non-relative references (personal or professional). Reference #1
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Reference #2


Reference #2
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Please select the answer that best describes the type of home you would be hosting the Ambassador in?
Please select the answer that best describes the type of home you would be hosting the Ambassador in?
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How many bedrooms are in the home?
 *
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How many bathrooms are in the home?
 *
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Type of Utilities? Select all that apply
Type of Utilities? Select all that apply
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Will the Odawara Ambassador share a bedroom?  If yes, please list with whom and his/her gender.
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Please provide a description (square footage, amenities provided etc...) of the bedroom proposed for the Ambassador.
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Is the residence the site of a business (e.g. daycare, farm)?
Is the residence the site of a business (e.g. daycare, farm)?
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List all other persons (adults and children) living in the home.  Include full name, gender, date of birth, and relationship to Host Family.
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Other than English, list other languages spoken in the home.
 *
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List all pets that you have in the home (include type, breed, etc..)
 *
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Has anyone living in the home ever been charged with a crime?  if yes, please state who in the home was charge and explain the charge.
Has anyone living in the home ever been charged with a crime? if yes, please state who in the home was charge and explain the charge.
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Does any household member have dietary restrictions? If yes, please explain.
Does any household member have dietary restrictions? If yes, please explain.
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Would you be willing to host an Ambassador with dietary restrictions (e.g vegetarian) ?
Would you be willing to host an Ambassador with dietary restrictions (e.g vegetarian) ?
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Will you provide the Ambassador three (3) meals per day?
Will you provide the Ambassador three (3) meals per day?
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Has any household member previously traveled abroad?  If yes, please explain.
Has any household member previously traveled abroad? If yes, please explain.
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Do you have a preference of hosting a male or female Ambassador?  If yes, please state male or female.
Do you have a preference of hosting a male or female Ambassador? If yes, please state male or female.
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Would you host an Ambassador who smokes? 
Would you host an Ambassador who smokes?
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Describe your expectations regarding the responsibilities and behavior of the Ambassador while in your home (e.g., homework, household chores, curfew (school night and weekend), access to refrigerator and food, drinking of alcoholic beverages, driving, smoking, computer/Internet/E-Mail)

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Please describe activities and/or sports each family member participates in (e.g., camping, hiking, dance, crafts, debate, drama, art, music, reading, soccer, baseball, horseback riding)
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Would any household member have difficulty hosting an Ambassador with different religious beliefs? 
Would any household member have difficulty hosting an Ambassador with different religious beliefs?
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Certification :  By checking the box below you certify that the information contained in this application, including all attachments and supporting materials, is true and correct to the best of your knowledge and that you certify that you have not withheld any information that would affect this application unfavorably, if disclosed.  You further understand that any omission or misrepresentation will result in your elimination from consideration as a host and may result in the dismissal from the program.

 *
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Upload Photos of the Host Family Home (including all of the following)

Outside of home (front, back, and sides), yard (front and back), all living areas, kitchen, Ambassador bedroom(s).

 *
Upload Photos of the Host Family Home (including all of the following) Outside of home (front, back, and sides), yard (front and back), all living areas, kitchen, Ambassador bedroom(s).
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