Active Citizens International Study Visit 2017-2018

Application to participate

Thank you for your interest in applying to take part in an Active Citizens International Study
Visit (ISV). International Study Visits give Active Citizens around the world the opportunity
to find out about the power of global connections by sharing their ideas and by thinking
critically about how they can work together on issues that affect society at the local,
national and international level.

In the UK, our delivery partners nominate two participants to take part in an ISV. The
Active Citizens team values these nominations, but it is still very important that you
complete the form carefully. You need to demonstrate your understanding of the role of an
ISV participant and what you will bring to it. If the team feels that you have not fully shown
this understanding, they will set up a conversation over the phone with you. This will be
conducted in a friendly and informal manner, and will be designed to give you the
opportunity to show how you fit the role and to ask any questions you may have. If the
team still has concerns about your ability to fulfil the role, they may choose not to offer you
a place at the ISV.

Deadlines for return of your completed form:

- UK1 (9-16 December 2017): 27 October 2017
- Sri Lanka (20-27 January 2018) and UK2 (3-10 February 2018): 28 November 2017

Please return your completed form to your British Council office directly.

Privacy Notice

The British Council will use the information that you are providing for the purposes of selecting participants
for International Study Visits, and for the planning and administration of these events. We shall pass this
information on to other bodies, for example conference venues and transport providers, in connection with
the delivery of the event. Where appropriate this will also be shared with the ISV master facilitators and the
organisations hosting the community visits. By giving us sensitive information about yourself you consent to
us using that information where necessary to ensure equality of services provided for you and your safety at
the event.

Where you have given permission for us to include your profile and/or email address in the participant pack,
these will also be shared with fellow participants and also relevant organisations and individuals involved in
hosting the International Study Visit, for example organisations hosting the community visits.

In the event of an emergency, we will share the details of the emergency contact whom you have nominated
with the relevant authorities (for example the British Councils Crisis team, your countrys Embassy/High
Commission etc.)

Under UK Data Protection law you have the right to ask for a copy of the information we hold on you, and the
right to ask us to correct any inaccuracies in that information. If you have concerns about how we have used
your personal information, you also have the right to complain to a privacy regulator. For detailed

Active Citizens ISV Application Form 2017-18.doc 1

information, please refer to the privacy section of our website, www.britishcouncil.org/privacy or contact your
local British Council office.

Personal information

Your full name

Your preferred name

Organisation through which you are

connected to the Active Citizens
programme
Your job title or role

The country you live in

Your country of origin or nationality if

different to above
Gender

Date of birth

Your address

Your direct email address

May we include your email address in YES / NO

the participant pack?
Direct mobile phone number

Social media username(s)

Please confirm you hold a passport

with at least 6 months left until expiry YES / NO
and are fit for travel to another country
How would you like us to contact you
if your application to take part in an
ISV is successful?
Please indicate which ISV you are UK1: 9-16 December 2017
applying for: Sri Lanka: 20-27 January 2018
UK2: 3-10 February 2018
Estimated cost for your travel

Draft travel details (estimated flight

times/cities of departure etc). Please
note a separate travel form will need
to be sent 3 weeks before the ISV with
exact flight numbers/times etc

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 About you

Please provide a brief biography about you, what motivates you, topics that
interest you and your experience in work, studies and/or the community (not more
than 200 words please).

Please describe your experience of the Active Citizens programme and what you
have achieved so far as an Active Citizen and in the wider work you do in your
community.

What does Globally Connected, Locally Engaged mean to you?

What do you want to learn from an international Active Citizens network and how
will taking part in the International Study Visit help you?

What will you do to make sure you put what you have learned into practice after
the International Study Visit? How will you share what you have learned with
others?

If you are selected for an ISV, we will create a participant profile from the
information you have given in this application. We would like to include this
profile in the participant pack that is given to participants and hosting
organisations (e.g. community visit hosts) to help with preparation for the ISV and
networking. Please indicate if you are happy for us to include your profile in the
pack.
Active Citizens ISV Application Form 2017-18.doc 3
 YES / NO

Disability-related requirements and other needs

Please outline any requirements you may have in relation to your physical or
mental health, disability, diet, religion, etc. that we will need to take account of.

The information that you give us will be treated confidentially, and only shared as
needed for the safe and successful hosting of the ISV. (How participant
information is shared is described in the Privacy Notice on page 1 of this form.)

If we need further details, we will ask you to complete an additional form with
more detailed questions or to talk it through with us over the phone, whichever
you are more comfortable with.

Reasonable adjustments are possible, and if we have concerns about our ability to
host you safely we will be in touch as soon as possible.

Emergency contact details

Please provide the name, telephone number (including country code) and
relationship to you of the person whom we should contact in the event of an
emergency.

Commitment

If you are offered a place at an ISV, you will be asked to sign a Participant
Agreement. This outlines the commitment that is required from all participants,
including:
- Completing the pre-visit tasks (researching the country you are visiting and
the other countries that will be represented; preparing information about
your own country; thinking about the skills and experiences you are
bringing and what you want to gain from the ISV);
- Using the Learning Journal as a reflection tool during the ISV;
- Sharing your learning with at least 15 others in your Active Citizens group
after the ISV;
- Thinking about ways of sustaining the global connections you will have
made.

By completing this form, you are confirming that you understand the commitment
that you would be making.

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Please note that we cannot guarantee to offer you a place at an International Study
Visit.

Acceptance of terms and conditions of the application

I accept the terms and conditions of this application:

Name:

Date:

Signature:

END

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