1 BIENVENIDO PASO 1. Llena la solicitud en internet PASO 2. Colecta y envía los documentos que se enlistan a continuación. Puedes enviarlos por en primera instancia, pero deberás entregarlos físicamente el día de tu entrevista o enviarlos por correo postal como se indica al final de este documento. PARA SOLICITAR ENTREVISTA: Una vez que hayas llenado tu solicitud en internet. Puedes solicitar entrevista escribiendo a ESTA ES LA LISTA DE FORMATOS O DOCUMENTOS QUE DEBERÁS DE ENTREGAR: (Las cartas de recomendación, referencias, carta de no antecedentes penales, etc. deben de estar en inglés o traducción al inglés. La traducción no necesita estar firmada ni sellada ni en membrete) 1. COPIA DE IDENTIFICACIÓN OFICIAL. Por ambos lados 2. COPIA DE COMPROBANTE DOMICILIARIO (no mayor a 3 meses de antigüedad) 3. MEDICAL FORM. Aquí se incluye el formato páginas 3 a PROOF OF STUDENT STATUS. Aquí se incluye el formato en la página 6, puedes usar este formato o bien puedes usar una constancia de estudios o carta oficial de tu escuela en su lugar. 5. PARTICIPANT REFERENCE FORM. Aquí se incluye el formato en la página 7 este debe ser llenado por un profesor, supervisor, jefe o exjefe. No debe ser la misma persona que llene la carta de recomendación. (Por favor asegura que todo esté bien llenado y se especifique el puesto y la institución o empresa de la persona que llena esta referencia. Debe de llenarse en inglés) (Puedes utilizar en lugar de estas referencias, los formatos digitales que vienen en la solicitud en internet.) 6. DOS CARTAS DE RECOMENDACIÓN No existe un formato específico. Solo es una carta de recomendación en hoja membretada, firmada y fechada y de ser posible sellada. (Si la carta no puede ser en hoja membretada, es necesario entonces contenga sello o tarjeta de presentación de la persona que recomienda). Asegúrate de que esta carta contemple lo siguiente: - Debe de ser de algún profesor, director, coordinador, supervisor, jefe, exjefe o ex profesor. (No familiares o amigos) - Que la carta indique cual es la relación de la persona contigo, es decir, que especifique si es o fue tu jefe, exjefe, maestro, etc. - Que contenga datos de contacto de quien te recomienda. 7. TERMS AND CONDITIONS Aquí se incluye el formato páginas 8, 9 8. CURRICULUM VITAE EN INGLÉS. Aquí se incluye un ejemplo en la página 10 (No es necesario hacerlo exactamente de acuerdo a este ejemplo, puedes utilizar otro formato) 9. COPIA DE PASAPORTE. Solamente copia de la página de foto y datos, no importa que este vencido. 10. CARTA DE NO ANTECEDENTES PENALES (POLICE BACKGROUND CHECK). Carta emitida por el departamento de Justicia Federal o Estatal en donde se hace constar que no se tienen antecedentes penales. (O en caso de tenerlos se explica cuales son ahí mismo). Cualquier duda o problema que tengas por favor comunícate con nosotros por o por teléfono.
2 Puedes enviar tus documentos escaneados por correo electrónico, y enviar posteriormente los originales a (Esta dirección es solamente para entrega de documentos ya sea en persona o por mensajería) Ole Staff Circuito Interior Juan Pablo II 3302 Local 5 Col. Las Ánimas, Puebla, Pue. Mexico 72400
3 Health History and Examination form for children, youth and Adults attending camps 1 (To be completed by the applicant) The information on this form is not part of the camper or staff acceptance process, but it s gathered to assist us in identifying appropriate care. Last Name First Name Birth date (mm/dd/yyyy) Age at camp Home address: City: State Zip Social security number (if any) Gender: Male Female address: Phone: Emergency contact #1: Relationship to applicant: address: Phone: Emergency contact #2: Relationship to applicant: address: Phone: Insurance Information Is the participant covered by family medical/hospital insurance? Yes No If so, indicate carrier or plan name: Policy: (Photocopy of front and back of health insurance must be attached to this form) HEALTH HISTORY (Check all that apply) Anemia Dizziness/Fainting Heart Disease Mumps Anorexia Ear infection Hepatitis A/B/C Pregnancy Arthritis Epilepsy/ Seizures Kidney Disease Rheumatic Fever Asthma Eye Problems Malaria Scarlet Fever Bulimia Gallbladder Problems Measles Tuberculosis Chicken pox German Measles Menstrual Problems Ulcers Depression Glandular fever Migraine /headaches Venereal Disease Diabetes Other: If you check any of the above, please give details (including dates) on a separate sheet of paper Place a check mark next to following organs or systems if there any known abnormalities? Cardiovascular Head, ears, nose, throat Reproductive Metabolic Respiratory Skin Eyes (including glasses or contacts) Gastrointestinal Genitourinary Musculoskeletal Nervous Other If you check any of the above, please give details (including dates) on a separate sheet of paper Do you suffer from any allergies? Allergies: Describe reaction: Management or treatment: Hay Fever Insect Sting Penicillin Other drugs Food Other Medications being taken Please list all medications taken routinely. Bring medication to last the entire time at camp. Keep it in original packing/bottle that identifies it. This person takes NO medication on a routine basis This Person takes medication as follows: Med#1 Dosage: Specific times taken each day Reason por taking Med#2 Dosage: Specific times taken each day Reason por taking Attach additional pages for more medications
4 Health History and Examination form for children, youth and Adults attending camps 2 RESTRICTIONS The following restrictions apply to this individual Does not eat red meat Does not eat pork Does not eat eggs Does not eat poultry Does not eat seafood Does not eat dairy products Other (describe): Explain any restrictions to activity (e.g. what cannot be done, what adaptations or limitations are necessary) GENERAL QUESTIONS Has/does the participant: Yes No Yes No 1. Had any recent injury, illness or infectious 17. Ever had problems with joints (knees, ankles)? disease? 2. Have a chronic or recurring illness/condition? 18. Have an orthodontic appliance being brought at 3. Ever been hospitalized? 19. Have any skin problems? 4. Ever had surgery? 20. Have diabetes? 5. Ever been knocked unconscious? 21. Have asthma? 6. Wear glasses, contacts? 22. Have mononucleosis in the past 12 months 7. Ever had frequent ear infections? 23. Had problems with diarrhea/constipation? 8. Ever passed out during or after exercise? 24. Had problems with sleepwalking 9. Ever been dizzy during or after exercise? 25. If female, have an abnormal menstrual history? 10. Ever had seizures? 26. Have a history of bed-wetting? 11. Ever had chest pain during or after exercise? 27. Ever had an eating disorder? 12. Ever had a head injury? 28. Ever had emotional difficulties for which camp? professional help was sought? 13. Have frequent headaches? 14. Ever had high blood pressure? 15. Ever been diagnosed with a heart murmur? 16. Ever had back problems? Please explain any yes answer, noting the number of questions Please check whether the applicant had been immunized against the following and provide date of immunization Chicken pox (varicella) Hepatitis B TP Mantoux test Diphtheria Haemophilus Influenzae B Tetanus Mumps Typhoid German Measles (rubella) Measles Polio Whooping Cough Use this space to provide any additional information about the participant s behavior and physical, emotional or mental health about which the camp should be aware I certify that all information given is true to the best of my knowledge, and I hereby give permission for emergency medical care should it be necessary Signature Date (mm/dd/yyyy)
5 Health History and Examination form for children, youth and Adults attending camps 3 (To be completed by the doctor) Last Name First Name Day of examination (mm/dd/yyyy) BP (blood pressure) Height (in feet and inches) Weight (in pounds) In my opinion the above applicant IS IS NOT able to participate in an active camp program The applicant is under the care of a physician for the following conditions: Recommendations and Restrictions at camp: Treatment to be continued at camp: Medications to be administered at camp (name, dosage, frequency): Any medically prescribed meal plan or dietary restrictions: Known allergies: Description of any limitation or restriction on camp activities: Additional information for health care staff at the camp: Signature of licensed Medical Personnel: (Firma y nombre completo del doctor) Title: (Titulo y cedula profesional) Adress: (Dirección) Phone:
7 J1 Participant Character Reference The person named below has made an application for sponsorship in the Exchange Visitor Program and is kindly requesting you provide a character reference on their behalf. We appreciate your help in the screening of the applicant. Their application and acceptance in the program is dependent on you completing this reference Last Name: First Name: Position applying for: Please complete the following information to the best of your knowledge High Above Average Average Low Communication Skills Maturity compared with peers Overall Health, energy and endurance Leadership skill Ability to get along with others Sense of humor Ability to adapt to new situations Ability to handle difficult situations Ability to accept responsibility Has the participant ever been investigated for allegations of child abuse? Has the participant ever been convicted of a crime? Is there any reason you are aware that this person should not work with children? Would you hire this person to work with child of your own Yes No Yes No Yes No Yes No Please use the space below to provide comment on the applicant's suitability for employment Your Name: Position/Organization: address: Phone: How long have you known the participant: What is your relationship with the participant: (e.g. English teacher, Supervisor, etc) I verify that the information on this reference accurately represents the applicant and is true to the best of my knowledge. Signature: (mm/dd/yyy)
8 2014 Ole-Life Adventures Participant Agreement Required Procedures and Documentation. Participant agrees to follow all required procedures and submit to Ole - Ole-Life Adventures all required documentation. Submit all the documents required in the Formats Instructions Complete the submission of this application packet Pay a $35 SEVIS fee Pay a $190 Program fee which includes the U.S. Embassy fee to get the Visa. Program Rules. Participant agrees to abide at all times to the all rules set forth by the US Government pertaining to J- 1 Exchange Visitor Programs. Behavior While On Program. Participant will conduct him/herself in a professional manner on the job and abide by all US and local laws while on the program. Further, Participant agrees to fulfill all terms and conditions as set forth in his/her employment agreement. Passport. Participant is required to report to Ole-Life Adventures any changes to or renewal of Participant's his/her offer of employment. Cross-Cultural Activities. Participant agrees to be active in getting involved in company and local events in order to foster cultural exchange. These activities include, but are not limited to, company gatherings, local sporting events, community seasonal festivals and events. Program Termination. Should Participant decide to leave his/her job for any reason and/or should Participant be terminated from a position, Participant must immediately contact the sponsor indicated in his/her visa and DS2019 form. Participant must have on hand at all times the numbers and contact info provided by Ole. Change of housing/contact info. Participant is required to inform Ole-Life Adventures should any housing or contact information change at any point during the program. Changes are required to be in writing and may be submitted to Ole-Life Adventures through or by ing Applying for US Social Security Number. Within the first two weeks in the US, Participant will apply for a US Social Security number. Participant should ask the employers assistance to get to the Social Security office. In the event tat the employer does not provide the necessary assistance to do so, participant must inform immediately to Ole-Life Adventures Active . Participant must have an active on file with Ole-Life Adventures for ease of communication. Participant should also call or Ole Life Adventures within the next 5 days after they arrive to camp to let know they are at camp. Flight Itinerary. Flight information must be faxed or ed to Ole-Life Adventures at least 15 days prior to departing home country. Participant Name: Participant Signature:
9 2014 Ole-Life Adventures Terms and Conditions 1. Fees. SEVIS and VISA fees and VISA must be paid before going to the embassy to apply for a J1 VISA. Any other expenses are explained to participant directly so he/she understands all costs involved. 2. Program Fee of $190. Must be paid in advanced, upon acceptance in the program, so the participant is able to be scheduled to assist to a U.S. consulate in a group appointment, as required by the Embassy. 3. Passport. Participant must have a valid passport with an expiration date at least until December Medical Insurance. Ole-Life Adventures provides the required insurance coverage. 5. Flights. Participant must purchase roundtrip airfare to and from the U.S. Participant must provide Ole-Life Adventures with copies of the flight itinerary and receipt prior to departure to US. 6. Paperwork and Documentation. Participant must complete all required paperwork and documentation in a timely manner. Failure to provide Ole-Life Adventures with information may result in delay or termination of his/her program. 7. Cancellations and Refunds. After interview, the accepted participant must cover the Program fee. In case the participant cancels or withdraws from the program prior to June 1 st of 2014, for any reasons, the participant must cover the fee of $150usd. In the case of a Visa Denial the Participant must provide proof of denial to Ole-Life Adventures and return the DS2019. If a participant is not offered a job after June 1 st he/she can withdraw from the program and receive a full reimbursement of Program fee. 8. Employment Time. Participant agrees that the minimum work time on the program will be three weeks and the maximum will be four months. 9. Post Employment Travels. Participant must return to his/her home country. At the end of the Participant's employment term, he/she may travel the U.S. for a maximum of 30 days before returning home if the school schedule allows. During this time the Participant may not leave and then return to the U.S., unless the Participant's DS-2019 has been signed by sponsor official. Participants wishing to leave and then return to the U.S. should call Ole-Life Adventures at least 2 weeks prior to leaving the U.S. so that Ole-Life Adventures may clearly explain the rules and regulations regarding traveling. Participant Name: Participant Signature:
10 Attach a Digital PHOTO Here. (Smile) CURRICULUM VITAE Objective: Apply for a support staff position, helping in the kitchen preferable. Available from _(date you can start working)_ until _(last day you can stay in the camp). Name: Alessandra Villanueva Martinez Address: Priv. Chs # 5 Col. Aredas Cholula, Puebla. México Postal Code 760 Telephone: +52 (222) Cell Phone Nationality: Mexican Date of Birth : January 1 st, 1988 Marital Status: Single Educational Qualifications: Aug Currently UGP (Universidad Gastronómica De puebla) Culinary Student. 5th Semester 2001 to 2004 Colegio Pola- Puebla, Pue. High-School Diploma with specialty in Electricity Employment to June 8 to Aug 18, 2007 Arteas Hotel, Cancún Quintana Roo Tel. (313) Cook (Pantry for 800 people) June 8 to Aug 17, 2006 Archimini Restaurant, Queretaro, Queretaro. Tel. (243) Cook (Pantry and Bakery for 380 people ) Italian Food Nov 14, 2004 to March 20, 2005 ZARA store. S.A. de C.V As a cashier and public service April 15 to April 20, 2005 Watuzi Watoto Camps in Africam Safari, (222) as a counselor. (Puebla, Mexico) Other Studies and Activities Course on Chocolatiere. June, 2007
11 Universidad de las Americas Puebla 300 hours duration. Hobbies and Interests Guitar: Play acoustic and electric since Soccer. Play since Member of the University Team. Took classes from 1995 to 2000 in the Puebla FC. Spoken Languages. Spanish Native English 90% spoken, 80%Written, 100% Read. Currently taking TOEFL courses. French 20%. Currently taking classes in basic level.
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