Individual Application Form

Applicant Information
First name
Last name
Gender
Birth date
Your current age
Your current grade level in school
Your email address
Your home mailing address
Your home phone number
Your cell phone or alternate number
Parent/Guardian Information
Name of parent/guardian
Phone number for your parents
Parent's email address
School Information
Name of school (if participating in your classroom)
Teacher/mentor name
School Address
School City
School State/Provice
School Zip/Postal code
School Country
Tell us a little about yourself
What do you like to do for fun/ hobbies?
What is your favorite subject in school?
How do you see yourself creating peace in your life each day?
Optional photo of yourself (max 1 MB, JPG format)
Agreement By submitting this form, I agree to abide by the PeacePal guidelines as described below, and I agree to be trustworthy and considerate with my PeacePal.

Peacepal Guidelines

By agreeing to join Project PeacePal, I promise to abide by these guidelines, and to
contact Project PeacePal immediately if I have any problems or concerns:

Respect the privacy of your PeacePal by keeping confidential all personal information including your PeacePal’s name and address.
Be prepared to gradually build a long term relationship with your PeacePal based on kindness, trust and honesty;
Talk with your PeacePal and your family and friends about how “Peace Begins In Me”
Be sensitive to your PeacePal and write about things that you may have in common. Your PeacePal may not have a PlayStation, television or go to the movies. Write about your life and ask your PeacePal to tell you about theirs.

`In a few instances you may not hear back from your PeacePal due to problems with mail or illness. Know that you have given a wonderful gift of yourself to this person, regardless of a response from them. We will happily provide you with an alternate PeacePal if this occurs.

Individual Application Form

Agreement

Peacepal Guidelines