Help Nurtures Hope Application

Adult Service Expedition or Young Adult Mentor & Leader Service Application

Join the Help Nurtures Hope Leadership Training and Service Expeditions to be part of something life-changing!
Read and follow the instructions carefully:
1. Please read and fill out ALL information requested on the following pages of this form. Sign via e-signature before submitting your application to Help Nurtures Hope. NOTE: Applicants younger than 18 years old must have parental/legal guardian signatures.
2. Where prompted in the application, please upload a quality digital headshot of yourself (the applicant) no larger than 3 MB.
3. Where prompted in the application, provide TWO references from two different adults, who have no familial relationship to you (the applicant).
4. Pay the $25.00 application fee.
5. Upon receipt of the application and payment, you will receive a confirmation email at the email address provided on your applicaiton.
6. A representative from Help Nurtures Hope will call you to schedule an interview date, time, and location. Please plan on being at the interview 30 minutes early and fully prepared.
Selection Process Disclaimer

Oftentimes due to the number of applicants requesting a specific expedition, the Help Nurtures Hope board must determine who will be selected for specific service expeditions based on all information and documentation provided in the application and interview.

Applicant qualification and selection are NEVER based on personal or familial data, including and not limited to gender, race, ethnicity, culture, religious affliation, demographics, or quantity of service.

EVERY applicant who provides Help Nurtures Hope with complete and honest information requested, who agrees to fully abide by the Help Nurtures Hope Disclaimer and Code of Conduct, and who participates in the interview has the equal opportunity of being fairly reviewed and selected for a specified service expedition.

Those qualified applicants who are not selected for a specific service expedition may be placed on a waiting list for the service expedition of choice or elect for priority placement and participation in another available service expedition with Help Nurtures Hope.
Application Instructions and Selection Process Disclaimer:*

Yes, I have read and understand the instructions for filling out and submitting this application.Yes, I have read, understand, and accept the Selection Process Disclaimer.
If you have any questions about Help Nurtures Hope, any of the service expeditions, or about the application process, please call Brontë at (801) 580-7678 or contact us by email at helpnurutreshope@gmail.com.

II. Personal Data:

Tell us about yourself
Headshot:*

Photo
Please upload a .jpeg Cancelof
Please make sure the spelling and information of your full name and all required fields matches your US Passport information as it will be used for all international reservations and legal documents.
Full Name:*

First NameMiddle NameLast Name
Birthdate:*

MonthDayYear
E-mail :*
Where the confirmation will be send to
Age :*
Gender:
Mobile No. :*

Area CodePhone Number
Home Address :*

Street Address

Street Address Line 2

CityState

Zip Code
Applicant's Occupation:
Employer:

III. Education and References
High School/GED
Graduation Date

MonthDayYear
College/University
Are you currently a student?

YesNo
Major Area of Study:
Degree Received:
Graduation Date

MonthDayYear
Other Education/Training
Degree/Certification Received:
Completion Date

MonthDayYear
Gives us an understanding of your involvement with education through academics, participation, honors, leadership, programs, clubs, awards received and more:
List your specific skills, training, and talents:
What languages do you know how to speak?
List some of your hobbies, sports and interests:
References
Provide TWO references from two different adults, who have no familial relationship to you (the applicant).
Full Name:

First NameLast Name
Relationship:
Company: (if applicable)
E-mail:
Where the confirmation will be send to
Contact Number:

Area CodePhone Number
Full Name:

First NameLast Name
Relationship:
Company: (if applicable)
E-mail:
Where the confirmation will be send to
Contact Number:

Area CodePhone Number

IV. Family Contact Information
Select one of the following:

SingleMarriedDivorcedWidowed
If applicable, please provide information about your spouse:
Spouse's Name

First NameLast Name
Spouse's Phone Number (Cell):

Area CodePhone Number
If spouse's address is different from the one listed in your personal data, please enter the address:
Spouse's Email
example@example.com
Spouse's Occupation and Employer
Do you have any family member(s) or friend(s) applying for a service expedition?

YesNo
Do you wish to be put with family member(s) or friend(s) on the same service expedition?

YesNo
If yes, please specify the name of the family member(s) or friend(s) and the reason for the request:
If no, please specify the name of the family member(s) or friend(s) and the reason for the request:
Emergency Contact
Emergency Contact:

First NameLast Name
Contact's Phone Number:

Area CodePhone Number

V. Applicant Questions
Community & Volunteer Service
How are you involved in volunteer service in your community?
What is your personal experience working with youth?
Do you have any previous national or international service expedition, humanitarian aid, or religious mission experience? If so, please share.
Help Nurtures Hope Service
How did you hear about the Help Nurtures Hope organization?
Why do you want to be a part of Help Nurtures Hope?
What are your expectations of the experience with Help Nurtures Hope?
What do you feel you contribute to the Help Nurtures Hope organization and team?
How will your education and work experience serve the team and others during the training and on the expedition?
Concerns
Do you have any physical, mental or emotional disabilities that we should know about? If so, please explain briefly. NOTE: each volunteer will complete a confidential medical history before the expedition dates.
Do you have any concerns that need to be addressed? If so, what are your concerns?
Your Story
In the following paragraph, please TELL YOUR STORY. Share your values, ambitions, achievements, personal goals, and anything else that you feel should be shared.

VI. Help Nurtures Hope Disclaimer
I understand that the cost of the Help Nurtures Hope program and expedition is $3,600. Upon being selected to serve, I will be responsible to pay a minimum of $500 by the first of each month until the cost is paid in full. A $500 deposit is required from me to secure my space on the team within the first month of being accepted. I also understand that payments to a nonprofit organization are nonrefundable.

Additionally, I understand that the cost includes airfare, all in-country transportation and translation, accommodations, food, clean drinking water, evacuation and emergency insurance, Help Nurtures Hope, Inc. program costs and administrative fees. It excludes any required travel documentation (passport, visas, etc.) or any recommended vaccinations, medical costs or prescriptions. I am also responsible for my personal expenses internationally, such as souvenirs, non-service activities, clothing, personal items, extra food, and extra beverages.

I understand that upon being selected to serve, I will commit to attending the program meetings held bimonthly, two overnight retreats, and five mandatory service/work days. I may only miss two program meetings.

I understand that I am personally responsible to complete 100 hours of local, genuine-need service before the expedition dates.

Our international experiences require each participant to be able to physically, mentally, emotionally, and socially cope with the extreme cultural change in food and diet as well as social and religious customs, with the physical environment of a developing country, and the psychological as well as emotional situations they may encounter and witness. I understand that for my continued ability to travel internationally and legally under the care and supervision of Help Nurtures Hope, Inc., I must provide a medical release form signed by a healthcare provider stating that I may travel with the group. Although emergency and evacuation insurance is provided, I understand that I must have my own medical insurance.

I understand that upon my selection to serve, I will be asked to complete other forms, including but not limited to media/social media release, policies, medical information, and Assumption of Risk, Waiver of Liability, Indemnification Agreement.

I certify that my answers are true and complete to the best of my knowledge.

I understand that false or misleading information in my application or interview may disqualify me as a candidate and result in my dismissal.
Verification*

I have thoroughly read, understood, and agreed to the Help Nurtures Hope Disclaimer.

VII. Summary of Understanding
SERVICE YEAR ACCEPTANCE:

Participants in the Help Nurture Hope, Inc. program are carefully chosen and interviewed by the Help Nurtures Hope, Inc. directors, staff, and selected team leaders. Participants will be selected based on an application that reflects a sincere desire to serve both locally and abroad, the strength and commitment to become a leader to the team and community, the ability to get along well with others and respect culture and its diversity, as well as the drive to use education, experiences, skills, passions and talents that will contribute to the team and leadership program.

NOTE: Submitting an application does not guarantee acceptance into the program.
LOCAL and NATIONAL SERVICE:

Local service is a critical element to the Help Nurtures Hope, Inc. program and to each team’s service year. Service is essential to our mission of creating lifetime leaders and humanitarians. Each participant will be required to contribute 100 hours of local service during the service year. Participants are responsible for recording and verifying exact dates and times of their service hours with a chosen mentor and validator. Participants younger than 24 will begin the Congressional Award that requires focused service as well as personal development and physical fitness.
INTERNATIONAL SERVICE PREPARATION:

Participants of the Help Nurtures Hope, Inc. program are responsible for following through on all requirements of the service year outlined in this document, team contact media, and in team meetings. There will be mandatory meetings held twice a month, 2 required overnight retreats, and 5 work/training days. The training taught throughout these meetings will aid in preparing participants for international service as well asleadership locally and abroad. Assignments and activities outside the mandatory meeting times may be included. It is the responsibility of each participant to complete the training and any additional assignments and action items. Participants are responsible to contact team leaders, facilitators, and mentors with any questions and concerns.
INTERNATIONAL SERVICE EXPEDITIONS:

Help Nurtures Hope, Inc. International Service Expeditions are not tourist vacations. While they will offer amazing service and cultural experiences, participants will inevitably encounter inconvenient, frustrating, and difficult situations and environments while traveling in developing countries and working with impoverished people. Participants should remain optimistic, flexible, and cooperative.

EXPEDITION SUPERVISION:

All Help Nurtures Hope, Inc. International Service Expeditions will be supervised and led by an expedition team leader, assistant team leader, and adult mentors, including an education leader, community outreach leader, media outreach leader, creative director, and medical professional working with an in-country coordinator and team.

EXPEDITION ARRANGEMENTS:

Help Nurtures Hope, Inc. will arrange for all international travel to, from, and
within country, as well as global evacuation and emergency insurance, all lodging and all meals in country. Participants are required to provide personal passports, required visas, all medical needs, and personal funds for personal purchases. No divergent tourist activities will be tolerated in conjunction with Help Nurtures Hope, Inc. International Service Expeditions, meetings, work/training days, or retreats. All expedition itineraries will provide opportunities for cultural experiences and interactions in country.
SUPPORT:

Help Nurtures Hope, Inc. wants and expects participant support and positive attitudes throughout the course of the applicant’s service year. Participants are required to abide by the CODE OF CONDUCT during the entire service year, both locally and internationally. They are to represent the values and ethics of Help Nurture’s Hope, Inc.’s mission at all times and in all situations.
Verification:*

I have read, understood, and accept the Help Nurtures Hope Summary of Understanding.

VIII: Code of Conduct
This code of conduct applies to all activities associated with Help Nurtures Hope, Inc., including but not limited to local and national service activities, team meetings, overnight retreats, local work/training days, international travel, and the Congressional Award.
- I agree to obey and sustain the laws of the United States and the country associated with my Help Nurtures Hope, Inc. service year team throughout local, national, and international service. I agree to make honest and complete declarations at customs.
- I will respect the property rights of others. This includes refraining from stealing, concealment, damage, or misuse of the property of others.
- I am not involved in, nor will I become involved in, alcohol and drug use, including possession, use, or distribution of any narcotic, dangerous, or illegal drug (as defined by applicable federal or state law), except as prescribed by a licensed medical practitioner. I understand that underage alcoholic drinking as per U.S. law (21 years old) as well as legal-age alcoholic consumption are prohibited during my Help Nurtures Hope, Inc. International Service Expedition from the moment I depart and until I return home, during all flights, layovers, and traveling abroad.
- I will respect the rights of others during the entire Help Nurtures Hope, Inc. experience locally, nationally, and internationally. This includes, but not limited to, physically or verbally abusing any person, sexually harassing any person, engaging in behaviors which endanger the health or safety of myself or any person, not obstructing or disrupting the privacy of any person or the mission performance of Help Nurtures Hope, Inc. activities at the direction of leaders associated with the organization.
- I will always respect the rules and direction of team leadership and mentors. I will stay with the team and participate in all team activities, unless otherwise directed by the team leadership. I, nor any other participant, will go out alone. I understand that any attempt to do so will be considered willful contempt for the Code of Conduct. During activities, I understand that I will be in a group of minimally three people, one of them being an adult leader or mentor.
- I understand that co-ed rooming, unless individuals are legally married, as well as public displays of intimate affection (anything other than friendly hugging) are not allowed during the service year or on the international service expedition. It is my objective in participating in the Help Nurtures Hope, Inc. program to be a part of the team and focused on the accomplishment of activities associated with the service experience. Additionally, any intimate relationship outside of marriage is strictly prohibited between team members and international community members as this puts into peril participant safety and international partnerships.
- Due to complex cultural differences and beliefs of the countries being served, I will not engage in any activities relating to body modification, including but not limited to getting a tattoo or piercing during the service year.
- I will be respectful in terms of dress code requirements as is culturally appropriate for both my local service location and international service expedition location. The team leader and international director will inform participants of required dress code. All participants are expected to respect and adhere to the dress code requests.
- I will use respectful and appropriate language, conversation, and gestures among my team members and the people of my international service area. I will use positive and uplifting words and refrain from defaming or offending the international culture.
- I will make my opportunity to serve a chance to be present among the people that I am serving and create meaningful connections at home and abroad. As such, I will respect the expectations set forth by my leaders and mentors regarding cell phone, internet,
  and social media use.
- I understand that each participant on the team is a representative of the Help Nurtures Hope, Inc. Non-profit Organization. As a participant, I will not attempt to further any personal cause or agenda—religious, political, or otherwise—in the name of Help
  Nurtures Hope or which is outside the stated or understood purposes of the Help Nurtures Hope, Inc. Organization.
- I understand that a single violation of this Code of Conduct may be grounds for expulsion from the service year at any time, locally or internationally. If internationally, I will return home early at my own or my legal guardian’s expense.
- I have read and understand this Code of Conduct and agree to abide by all its requirements.
Verification:*

I have read, understood and accept to abide by the Help Nurtures Hope Code of Conduct.

IX. E-Signatures

for Application, Disclaimer, Summary of Understanding & Code of Conduct
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation to the provided email address that your application was received. Please print all pages for your records and retain as verification of your application.
E-Signature of Applicant:*
Date*

MonthDayYear
APPLICATION FEE PAYMENT OPTIONS:

$25.00

Pay in the following ways:
- VENMO: @Help-Nurtures-Hope
- CHECK: Made payable to Help Nurtures Hope**
- CARD: Help Nurtures Hope Fundraising Store
Note: No application submission will be considered until Help Nurtures Hope receives the full payment.

**Send check payments to

Help Nurtures Hope, Inc.
P.O. Box 521521
Salt Lake City, Utah 84152
Should be Empty:

Adult Service Expedition or Young Adult Mentor & Leader Service Application

I: Leadership

II. Personal Data:

III. Education and References

References

IV. Family Contact Information

Emergency Contact

V. Applicant Questions

VI. Help Nurtures Hope Disclaimer

VII. Summary of Understanding

VIII: Code of Conduct

IX. E-Signatures

Help Nurtures Hope, Inc.P.O. Box 521521Salt Lake City, Utah 84152

Help Nurtures Hope, Inc.
P.O. Box 521521
Salt Lake City, Utah 84152