Instructions for completing a FillablePDF formPlease review the following instructions for successfully completing the Ambassador Applicationand Agreement fillable PDF form: Use only the latest version of Adobe Reader to complete fillable PDF forms. Macintoshand Windows versions of the free Adobe Reader are available from Adobeat http://get.adobe.com/reader/. Before completing the application, save the application form (PDF format) to a location onyour computer. (Example: Desktop or Documents). Instructions: Right click on the form and click “Save as”. Save to your Desktop or Documents. Once you have saved the form to your computer, you are ready to complete the form. Open the Ambassador Application and Agreement form. After you have completed the form, save a final version of the file to your computer. When ready, don’t forget to attach the Ambassador Application and Agreement form viaemail to the Ambassador Coordinator. Do not complete the form online within your web browser, your datawill NOT be saved. Please save it to your computer first, then fill itout!
AMBASSADOR APPLICATION AND AGREEMENTA Friendship Force Journey offers an opportunity for people from different parts of the world to share their lives with each other in the spirit of friendship. The success ofthe experience depends on the extent to which participants can build friendships, exercise flexibility, adapt to unforeseen difficulties, and promote understanding.The following information is needed to help Friendship Force International and Ambassador Coordinators select Ambassadors who are representative of their communityor region and is a sincere global citizen in the service of Friendship Force's mission to make the world a friendlier, more peaceful place. In the event the applicant is not able tomeet in person with the Ambassador Coordinator, you will be asked to provide references and other supporting documentation. Detailed information also helps us matchAmbassadors with host families and activities of interest designed to make the program experience a more enriching opportunity for you. Each applicant must completeand sign the Application and Agreement. Thank you for your cooperation.AMBASSADOR INFORMATIONLast name:Is this your legal name?YesFirst:Middle:If not, what is your legal name? (as shown on passport)Marital status:Birth date: (MM/DD/YY)Age:Gender:NoAddress:Home phone no.:Cell phone no.:Email:Nationality:Passport Number:Passport Expiration Date:If traveling with someone else, please complete below (each applicant should submit their own application).Name:Relationship:Age:Journey number and/or name you are applying to:AMBASSADOR PERSONAL HISTORYPlease note any languages you speak other than your own and your proficiency (Excellent, Good, Fair, Poor)I can speak/write:Proficiency:Are you currently working?YesI can speak/write:Occupation (previous if retired):NoHave you ever participated in a home‐stay (or similar) before?YesIf yes, were you a: (Host, Visitor, Both)NoAre you a member of the Friendship Force?YesProficiency:If yes, which club?If no, how did you learn about FFI?NoPlease describe your interests and hobbies relative to the destination or theme you are applying for:Do you Smoke?YesNoDo you mind if your host smokes inside the home?YesNoAre you comfortable with pets living inside the host’shome?Yes1No
HEALTH AND MOBILITYParticipation in a Friendship Force home‐stay may require a greater level of physical activity than an Ambassador is accustomed to, such as carrying luggage, climbingstairs, riding public transportation, and walking longer distances, among others. For more specific health and mobility requirements for this program, please ask theAmbassador Coordinator for the Health and Mobility Checklist from the host club.Ambassadors may be required to provide supporting medical documentation to be accepted.Are you able to carry your ownluggage upstairs, and/or overlong periods of time by yourself?YesNoAre you able to climb a flight ofstairs several times a day ifneeded, without assistance?YesIf no, please elaborate:NoIn the past three years, have youhad any major health issue thatwould preclude you fromcarrying out active elements of aFriendship Force journey?YesIf no, please elaborate:NoAre you able to ride andnavigate on publictransportation easily, perhapsseveral times in a day?YesIf no, please elaborate:If yes, please elaborate:NoHow would you describe yourown day to day activity level athome, on your own?Please select one:Do you have any particular diet,health, medical or allergy issuesthat require specialconsideration?If yes, please specify (examples‐ vegetarian, allergy to penicillin or animals, high blood pressure) Ambassadors may be required toprovide supporting medical documentation from their doctor to be accepted on this program.YesNot very activeActive SometimesActive every dayVery activeNoPlease provide a reference that your Ambassador Coordinator or Friendship Force International may contact to verify your ability to participate fully in this program.(preferably the last Ambassador or Host Coordinator that you traveled with):Name:Phone number:Email:Relationship to you:Name:Phone number:Email:Relationship to you:EMERGENCY CONTACT INFORMATIONPerson to contact in case of emergency:Relationship:Home phone:Work phone:Email:Name:Name:STATEMENT OF PURPOSEFriendship Force International considers each ambassador and each host to be a “Citizen Diplomat,” whom we entrust as a person who is committed to improvinginternational relationships through people‐to‐people diplomacy during and after the program. To help us and your Ambassador Coordinator evaluate your application,please write a brief personal goal that you wish to accomplish from this experience. Please also describe how you will keep the personal and institutional relationshipsalive after you return home.2
FRIENDSHIP FORCE INTERNATIONALAMBASSADOR APPLICATION AND AGREEMENTFriendship Force International was founded in 1977 with a single mission: to promote global understanding across the barriers thatseparate people. A nonprofit organization, Friendship Force International is active in more than 70 countries, promoting friendshipand goodwill through an extensive program of more than 400 homestays each year. In consideration of his/her selection, the personsigning this Agreement ("Ambassador") agrees to the following:1. The Ambassador Fee entitles the Ambassador to participate in a specific journey and covers only the items specified in theitinerary. The schedule of payment of Ambassador Fees must be observed.2. The Ambassador recognizes that connected with any travel there are risks of loss, damage, and injury to persons and property,and the Ambassador is willing to assume and bear those risks. The Ambassador also recognizes that he/she is responsible forcomplying with all laws of all countries visited. Therefore, the Ambassador, in consideration of his/her selection by FriendshipForce International, agrees to and does hereby release, indemnify, and hold harmless Friendship Force International (which shallinclude the directors, officers, and employees thereof, as well as its volunteer workers) from all claims, actions, and causes of actionbased upon or by reason of any loss, damage, or injury to the Ambassador's person or property, arising out of or in any mannerconnected with any aspect of the program or by reason of the Ambassador's failure to comply with any law in any country in whichhe/she may travel in connection with the program. Friendship Force International shall have no liability or obligation to return theAmbassador to his/her home community if the Ambassador should miss the return trip due to illness, injury, failure to report tothe airport at the prescribed time, or for any other reason.3. All Friendship Force Ambassadors are required to secure adequate travel and medical insurance to cover emergencies duringtheir journey. No travel, health, or accident insurance is provided by Friendship Force International, although one may berecommended. This requirement can be fulfilled through the Ambassador’s existing insurance policy if it covers internationaltravel, including emergency repatriation, or through a separate travel insurance policy. All travel will be subject to regulations andlimitations contained in the ticket(s) issued to the Ambassador.4. Any request for cancellation of this agreement must be made in writing to the local Ambassador and Host Coordinator and to theFriendship Force International Regional Support Manager overseeing the specific journey. If an Ambassador cancels more than 60days before departure, FFI will refund all FFI Ambassador Fees and Host Club Program Fees already paid. If an Ambassador cancels60 days or less prior to the departure, FFI has no obligation to refund the ambassador fee paid. If FFI cancels a journey, all FFIAmbassador Fees and Host Club Program Fees paid will be returned to Ambassadors. If this ambassador agreement is not for aclub‐to‐club journey, but instead for a themed or Global Journey please consult your FFI Regional Support Manager for cancellationand refund policies.5. Friendship Force International may cancel this agreement if it is unsuccessful in establishing a journey which satisfies the goals ofFriendship Force International for any reason, including cancellation of or unacceptable changes to the airline arrangements orfailure of the local committee to recruit the required number of Ambassadors. In such cases, the Ambassador Fee will be refundedexcept the 25 portion designated as non‐refundable.6. If Friendship Force International is making travel arrangements for your journey, any price increase for transportation will bepassed on to the Ambassador until the time that the full Ambassador Fee is received at the headquarters office of Friendship ForceInternational in Atlanta, Georgia, USA. After that time, no increase will be passed on to the Ambassador, except in the case ofcarrier or routing changes beyond the control of Friendship Force International.7. The Friendship Force Ambassador hereby agrees to follow the provisions stated above and: a) to accept travel arrangements asarranged by Friendship Force International, where applicable b) to participate fully in the homestay arrangements as arranged(unless previously discussed and adjusted), c) to pay the Ambassador Fee when due, d) to accept the decision making authority ofthe Ambassador and Host Coordinator during the program, e) to accept that the journey is a public event and that the photographand name of g the Ambassador may be used by the local and national media, Friendship Force clubs and Friendship ForceInternational in their publications, online and social media; and f) to comply with all commitments made to Friendship Force3
International as covered by this form, and the ‘Policies and Procedures’ Ambassador standards established by Friendship ForceInternational found here.8. Upon acceptance of the Ambassador into the program, this Agreement shall become effective and binding upon FriendshipForce International and the Ambassador, and shall be governed by the laws of the state of Georgia, USA. No representations, orstatements, whether oral or written, other than those contained herein, shall be binding on Friendship Force International. Inthe event the Ambassador fails to abide by any of the terms and conditions of this agreement, Friendship Force Internationalmay terminate this Agreement without any penalty or liability to Friendship Force International.Ambassador Pledge:My main objective as I join this journey is for cultural understanding, global friendship building and to make the world a morepeaceful place. My health is good enough to keep up with the group activities as planned in the initial itinerary and I state that myanswers in the Health and Mobility section of this form are true and accurate.As an ambassador, I am aware that my actions reflect on myself as a citizen diplomat, and as a representative of Friendship Forceand its mission, the country and community I come from and the club I am a member of. I promise to conduct myself in anexemplary manner. I understand the Ambassador Coordinator of this journey has been given authority by Friendship ForceInternational headquarters to lead and conduct this program for the best interests of all parties concerned. The Ambassador andHost Coordinator has the authority to remove any person from a journey who is not in compliance with the goals of FriendshipForce International. In case there is a need to use hotels or other accommodations as auxiliary housing, or a need or desire on mypart for a single room on the add‐on part of the program, I will bear the expense.I have read the Ambassador Agreement provided with this Application and accept its terms.I hereby agree to secure adequate travel and medical insurance for the duration of the journey.YesNoIf no, I hereby waive the requirement of Friendship Force International which states that all participants carry travelinsurance; and I agree to release Friendship Force International, its agents, the Ambassador Coordinator, my host and anyvendors who participate in this program from liability, loss or damages:I agreeI certify that I am 18 years of age or older and have completed this application to the best of my knowledge and believe it is true.Signature of AmbassadorDateSignature of Parent or GuardianDateIf Ambassador is under 18 years old,both signatures are required.Ambassadors under 18 must travel with a parent or guardian. Ambassadors under 16 must be hosted together with a parent orguardian.Name of guardian for youth under 18:*If I am below 18, I am including a letter of responsibility by my guardian, parent or adult supervisor allowing me to take part in allactivities of this program. Revised February 2017 17 Friendship Force International, Inc.4