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RSIS Student Application Form




School support for candidates for RSIS Projects (to be completed by the Head/Principal or RS Rep):


|Student’s Name: Marcia de los Rios |School: Markham College |

|What positions of authority has he/she held in your ||
|school? | |
|What contribution has he/she made to your social service | |
|programme?| |
|Is this student open to new experiences and challenges? | |
|How well does he/she function in a group situation? ||
|Will he/she accept the authority of the Project Leader | |
|and abide by the rules set down by RSIS and the Leader? | |
|Does he/she have any medical/emotional problems that ||
|might affect his/her performance on the Project? | |
| | |
|Has the student ever been involved inany serious | |
|disciplinary action at the school? | |
|Comments on the suitability of the student: ||
| | |
| | |

We are most grateful for your help in completing this form and would like to stressthat we are not just looking for “saints” or perfect students – it takes all sorts to create a great team. However, it is imperative that we are aware of any issues that may present a challenge to individual students so that we can prepare accordingly.

Signed (Head/Principal or RS Rep)………………………………………………..……

RSIS STUDENT APPLICATION FORM
Please ensure you read the Information Sheet (onthe RSIS website) carefully before completing your application form to find out specific details of the project for which you are applying.

Privacy Statement
All information contained on this form will be treated in confidence. Only the RSIS Project Manager, Admin. Assistant and adult Project Leadership Team will see these details. Information will not be submitted to any organisationoutside Round Square (except medical information submitted to hospitals or doctors in case of an incident while overseas).

WHERE POSSIBLE, PLEASE COMPLETE THIS FORM CLEARLY IN WORD AND SEND AS AN EMAIL ATTACHMENT

|Name (as it appears in your passport): Marcia Valeria de los Rios |Project applying for: |
|Surname: de los Rios Pérez...