India: UU Music Leader's Tour Registration

India: UU Music Leader's Tour Registration

UU Music Leaders are invited to participate in a two-week experience sharing music and learning with UUA justice partners and Unitarian congregations in India. The UU College of Social Justice and the UUA are hosting this tour, which plans to visit a social justice organization near Mumbai, and the school it runs for Adivasi girls; a justice organization in central India that employs the music of Kabir in its work; and Unitarian churches in the Khasi Hills of Northeast India. Prior to traveling, participants will engage in the UU College of Social Justice study guide and will learn music to be performed in India. Priority will be given to current and former Music Leaders in UU congregations. Program cost $2,100 (based on double occupancy; $250 single room supplement), plus international airfare, visa, and travel insurance. Dates: January 23rd-February 6th, 2020.

Registrant Information

First Name

Last Name

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City

State

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Primary Phone Number

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Email Address

Birthday

Month

Day

Year

Religious Affiliation

What is your religious affiliation? (Check all that apply)

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In which region is your congregation located?

Which New England UU Congregation are you affiliated with?

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Which Mid-Atlantic UU Congregation are you affiliated with?

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Which Midwest UU Congregation are you affiliated with?

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Which South Atlantic UU Congregation are you affiliated with?

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Which South Non-Atlantic UU Congregation are you affiliated with?

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Which Mountain UU Congregation are you affiliated with?

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Which Pacific UU Congregation are you affiliated with?

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Which Canadian Congregation are you affiliated with?

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Which International Congregation are you affiliated with?

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How would you describe your racial background?

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Are you Hispanic/Latinx?

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What is your gender identity?

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Are there other aspects of your identity that you would like to share with us?

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Are you a UU Music Leader? Music Leaders may be volunteer or paid staff in UU Congregations, such as music directors, choir directors, keyboardists, composers, or traveling UU musicians.

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Are you a US Citizen?

If you are not a U.S. Citizen, please fill out the information below.

Visa Number

Registration Number for Permanent Residents

Country of Citizenship

Please describe your general state of fitness, including any physical limitations and/or restrictions, disabilities, allergies, etc. In what physical activity do you regularly participate to stay fit and healthy?.

Please note that this is to give us a general sense of your ability with regards to the physical requirements of the trip. More detailed information about medical conditions, allergies, and medications will be requested upon preliminary acceptance into the program

Please write an essay explaining your interest in this opportunity, describing relevant skills and life experiences you would bring to it, and demonstrating your commitment to social justice. What interests you about this specific trip? What do you hope to gain from this experience? How do you imagine utilizing the experience when you return home?

Financial Information

The cost of this journey is $2,100 per person for those sharing a room and $2,350 per person for travelers who would prefer a single room, wherever possible. The price includes all housing, food, translation, partner honoraria, and in-country travel. It does NOT include round-trip international airfare to India or costs associated with visas, vaccinations, and travel insurance.

What room option would you like?

Share a room ($2,100)Single room where possible ($2,350)

Trip Requirements

Please read the following carefully and check that you understand and agree below.

1.) I understand that I am required to have had a tetanus shot within 9 years of the trip start date.

2.) I understand that UUCSJ strongly recommends that in advance of my program, I review the Center for Disease Control's immunization recommendations for my destination; and suggest that I may wish to consult a travel clinic for advice.

3.) I understand that I am required to have health insurance that covers me in the destination country for the duration of the trip (Medicaid, Medicare, and VA plans do NOT cover internationally - if one of these is your regular plan, you will need to purchase supplemental health insurance).

4.) I understand that it is my responsibility to make sure my health insurance covers the destination, and that I will provide my insurance details to UUCSJ prior to departure.

5.) I understand that I am required to have a current passport and may need to obtain a visa before the program start date for international journeys. I understand that UUCSJ can assist me with some of the information needed for the visa application, but that applying and obtaining the visa is my responsibility.

I have carefully read the statements above and agree to each.

How did you hear about this UUCSJ Program?

Other:

Electronic Signature (Type Name)

Today's Date

Parent/Guardian Electronic Signature if under 18 years of age (Type Name)

Contact Information