Haiti Application 2013

Haiti Student Application
May 2013

Mr. Milner and his family will lead a select group of 10 students to Zanmi Beni in Haiti from Saturday, May 25-Friday May 31, 2013.

Print out, complete, and return this application to Mr. Milner by Friday, February 1. You will receive a reply by e-mail by February 3.
(I've attached the application in a word document below.)

Name:

E-mail:

What languages do you speak?


Why do you want to go to Haiti?







The trip will cost approximately $1900. Describe how you plan to fund your trip (grants, fundraising, family).








Describe how you have responded to any new and/or challenging situation:







List any experiences you have had outside of your culture, country or beyond your comfort zone and explain what they taught you.








When was the last time you were bored? What did you do about it?








Project
Describe the project you plan to execute in Haiti. You may collaborate with others on this project.

For example, my wife is going to make a book of pictures, corresponding words in Kreyol, and signs for those words. She is going to use the book to help Patrick learn American Sign Language.

I am going to teach the kids a daily 30-minute ESL lesson.

Kids at Zanmi Beni range from age 3-18. They do not speak English. Some are able, others are in wheelchairs, and many suffer from cognitive and physical disabilities.

Think about what would benefit the kids of Zanmi Beni, what you are good at and what you like to do.

Project Title:


What you plan to do (one sentence max.):



Project Goal:





Plan of Execution:
(time needed, ages reached, numbers, logistics, materials)





















Please feel free to add any relevant information that may not have been covered by this application.

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