Barvalipe – The 3rd Roma Pride Summer School Application form Application Deadline: June 25, 2013 icon

Barvalipe – The 3rd Roma Pride Summer School Application form Application Deadline: June 25, 2013


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Barvalipe – The 3rd Roma Pride Summer School


Application form


Application Deadline: June 25, 2013


Thank you for your interest in Barvalipe - The 3rd Roma Pride Summer School. Selected participants will attend the summer school in Montenegro, for 10 days including a study trip to Jasenovac concentration camp in Croatia.


The 3rd Roma Pride Summer School intends to create a young Roma community (group of people, or network) with an enriched identity who will be able to use tools for active citizenship, committed to promote the Roma interests. Participants will explore the roots and future of Roma identity in a learning environment with distinguished Roma professors and civil leaders. The Summer School intends to build pride as being an essential element to motivate the group to take action and bring change for the common cause.


Please note that an application is only considered to be a full application when all of the requested documents listed below are submitted.





^ 1. PERSONAL DATA

Last name:

First name:

Birth date (dd/mm/yyyy):

Country:

Gender: Male Female

Marital status:

Nationality:

Any special needs (vegetarian, allergy etc.)



^ 2. CONTACT DETAILS

Home country address

Street:

Zip/postal Code:

Town/city:

Country:

Phone:

Mobile:

E-mail:



^ 3. PASSPORT INFORMATION




Passport number:

Please indicate if you need a visa:

Date and Place of issue:

Expiration date:






4. COSTS:


Please be informed that costs for travel1, accommodation, meals and visa (if needed) will be covered by the organizers.


Upon the arrival participants will be asked to pay a 20 Euro contribution fee. The collected amount will be used for a cause decided afterwards by a joint agreement of all participants.


^ I hereby confirm that I will pay the 20 Euro contribution fee once I arrive in the School


Getting to know you

Barvalipe - The 3rd Summer School brings together participants from different cultural and educational backgrounds. This will give you the opportunity to interact with people of different profiles, countries and experiences.

Answering the questions from the below questionnaire will give you an insight into your own ethnic identity.


^ Please answer the questions below so that we can create a learning environment and to shape the School according to your experience (max. 150 words).





1. What is your greatest achievement (e.g. personal, academic, and professional)?



2. What are the biggest problems Roma are facing in your community? Describe one of them and what action would you take if you have 1000 euro?



3. How would you see yourself in few years?





Part A: Please choose the appropriate answer (underline where applicable):




In terms of ethnic group, I consider myself as:

  1. Roma

  2. Non-Roma

Do you declare yourself publicly as Roma?

  1. Yes, I do.

  2. No, I do not.

Most people think that I am _________

What is your relationship with the Roma community?


a) I live in the Roma community

b) I have some relatives

c) No connection

d) Other _________

Do you speak Romanes?


  1. I speak fluently.

  2. I understand but I don’t speak.

  3. I do not speak.

Other_________

What is/are the language(s) spoken in your family? _________

Have you had the opportunity to learn Roma language and history?

Yes, in___________ No, I would like to___________

Are / were you part of any Roma NGO/ organization?

Yes, in____________ No, Why?


Are/Were you REF scholarship, OSF programs beneficiary? If Yes, please list the programs, projects, etc. you were taking part in?


^ Part B: Use the numbers below to indicate how much you agree or disagree with each statement. (4) Strongly agree (3) Agree (2) Disagree (1) Strongly disagree:




1 - I have spent time trying to find out more about my ethnic group, such as its history, traditions, and customs. ________

2- I am active in organizations or social groups that include mostly members of my own ethnic group. __________

3 - I have a clear sense of my ethnic background and what it means for me. ______________

4- I think a lot about how my life will be affected by my ethnic group membership. __________

5 - I am happy that I am a member of the group I belong to.____________

6 - I have a strong sense of belonging to my own ethnic group. __________

7 - I understand pretty well what my ethnic group membership means to me. __________

8 - In order to learn more about my ethnic background, I have often talked to other people about my ethnic group. ___________

9- I have a lot of pride in my ethnic group. __________

10-I participate in cultural practices of my own group, such as special food, music, or customs. __________

11-I feel a strong connection with my own ethnic group. __________

12- I feel good about my cultural or ethnic background. __________


Part C: The questions below are design to assess your previous knowledge about Roma. If you consider that you are not knowledgeable enough to comment, feel free to skip it. (max. 150 words)




  1. What do you know about Roma history?




  1. Have you (or some friend/ family member) ever faced some sort of discrimination and how did you cope with it?




  1. What does it mean for you to identify yourself as Roma and how would you asses your relationship with the Roma community?




4. Name three things why you are proud to be Roma. Please list three things if you feel ashamed of being Roma?




Date: Signature:


Please send your application by June 25, 2013 to: e-mail: barvalipe2013@gmail.com). Late applications will not be considered.


Please include “Barvalipe: The 3rd Roma Pride Summer School” in the subject of your message.

1 Local transportation costs from your home town to the airport/bus/train station will not be covered.


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