Basic Guidelines:

We prefer applicants who have previously worked with us or have been involved in the Free Burma movement. Please return application electronically. Even if you are not sure you are planning to go, please apply, and indicate so on your application. Please know that while it is not completely mandatory to fundraise for the mission, you will be received much more enthusiastically if you do intend to fundraise. Please include specific plans for fundraising in your application.

Application Procedure:

Your application will be carefully reviewed. Please be available to talk in person or over the phone with BHM members for discussion of roles, reference checks, or other items.

Name:

Mailing Address:

E-mail Address:

Phone Number:

Cell:

References: At least two must be professional, and preferably people you’ve worked or traveled with under stressful situations.

Name:

Phone Number:

E-mail Address:

Years Known:

Briefly Describe how you know each other:

Name:

Phone Number:

E-mail Address:

Years Known:

Briefly Describe how you know each other:

Name:

Phone Number:

E-mail Address:

Years Known:

Briefly Describe how you know each other:

Member(s) of BHM who will vouch for me:

Member(s) of BHM I have worked with previously:

Please describe your activist experience. What groups have you worked with and in what capacity? (Or send your resume.)

Please describe any Medical Training you have:

Please describe any Technical Skills (Computer, Security, Videography, Photography, etc.) you have:

Please describe any travel experience internationally, particularly in Asia:

What fundraising experience do you have?

Why do you want to participate? What do you personally hope to get from this experience? What qualities do you feel you offer to the group?

What do you envision your long-term involvement with Burma Humanitarian Mission to be?

Do you have any medical conditions? If so, please describe them.

Are you physically fit and able to hike quickly for extended periods?

Please describe any leadership training, conflict resolution training, or non-violence training you’ve had:

Describe the best and worst experiences you’ve had traveling with a group:

How do you plan to pay for your travel expenses?

What is your timeline?

Is it flexible?

How do you feel about armed defense? Are there exceptions to non-violence?

I understand that should I participate with BHM, I am acting solely as an individual. I am responsible for my own health, safety and decisions. It is my responsibility to attain a security and cultural briefing from a BHM member before departing from the United States. I also understand that at any point during the travels in Thailand, I may be asked not to participate in certain activities or parts of the journey, if this is considered in the best interests of the group. I also understand that I am responsible for determining my own comfort levels. If I am uncomfortable it is up to me to voice my concerns to other group members. It is also up to me to decide whether or not I am willing to participate in anything.

I agree not to talk to others, except with BHM members, about the activities of BHM or my participation until I have received a security and cultural briefings. (It is ok to mention to folks in our community you are thinking about going; however, do not mention any dates or details)

I understand it is in my best interests to learn as much about Burma and the Karen before the trip. BHM members can provide information.

I also understand that participating in a mission does not necessarily make me a full member or representative of BHM.

Signed:

Date: