full application - Lifetouch Memory Mission

2017 LIFETOUCH
MEMORY MISSION
Dominican Republic | Volunteer Information & Application
In partnership with AASA, NAESP, NASSP, NSBA & National PTA
BUILDING A SCHOOL IS BUILDING HOPE
In January 2017, some 50 volunteers will
depart on a Lifetouch Memory Mission®
to the Dominican Republic to continue to
build an elementary school. On previous
missions, volunteers have built elementary schools serving hundreds of children
in small, impoverished, mountain villages.
Memory Mission volunteers work on a
variety of projects, including block and concrete work and stucco and paint finishing for
school classrooms. They also visit with community members to learn more about them
-- their lives, families, traditions -- and the
Dominican culture.
Since its inception in 2000, Lifetouch
employees have traveled to destinations
around the world to spend a week in inten-
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sive volunteer service. Lifetouch hands
have helped rebuild a village in war-ravaged Kosovo, repair homes in Appalachia,
establish a children’s center in Jamaica,
and construct a bridge in the land of the
Navajo in Arizona. They have built twelve
schools across Haiti and the Dominican
Republic. Memory Mission volunteers
have also provided on-site assistance to
victims of natural disasters throughout the
United States, including Hurricane Katrina
in New Orleans, floods in the Dakotas,
fires in California, and tornadoes across
the Midwest.
Joining Lifetouch volunteers are superintendents, principals, and members of the
School Superintendents Association (AASA),
the National Association of Elementary
School Principals (NAESP), the National
Association of Secondary School Principals
(NASSP), National School Boards Association (NSBA), National PTA, along with educators from schools across North America.
Learn more about the Lifetouch Memory Mission, the January 2017 trip to continue building an elementary school in the
Dominican Republic and how to be a part
of this life-changing experience at lifetouchmemorymission.com.
Application deadline is September 26, 2016.
2017 LIFETOUCH MEMORY MISSION
®
Constanza, Dominican Republic | January 16 - January 24
SELECTION OF VOLUNTEERS
The School Superintendents Association (AASA), the National Association of
Elementary School Principals (NAESP), the National Association of Secondary School
Principals (NASSP), the National School Boards Association (NSBA) and National
PTA, in partnership with Lifetouch (“Sponsors”), are sending volunteers from each
organization for a Lifetouch Memory Mission to the Dominican Republic.
During this Memory Mission, volunteers will help to construct a school, assist with
needed chores, visit with community members and provide a “Picture Day” for children
and families.
Who
Members of AASA, NAESP, NASSP, NSBA and National PTA, educators and eligible
Lifetouch employees in good standing as of the date of travel who are residents of the
United States or Canada and who will be 21 years of age as of September 26, 2016.
Participants of the past Memory Missions are not eligible.
When
Memory Mission dates are Monday, January 16, 2017, through Tuesday, January 24, 2017.
Where
Constanza is an agricultural community in the mountains northwest of the capital,
Santo Domingo.
Passport
A passport valid through August 1, 2017, is required for travel to the Dominican
Republic. Visit http://travel.state.gov/ or http://passportcanada.gc.ca for information and fees.
Obtaining a passport can be an involved process. Allow an appropriate length of time for
this process. The volunteer must pay any fees for this service.
Cost
While the cost of sending volunteers is borne by Lifetouch through company
contributions and fundraising efforts, Sponsors, employees, friends and families,
participants are encouraged to help fundraise to offset the cost of building materials,
supplies and expenses.
Transportation, Meals & Lodging
Volunteers will travel by coach air transportation from their nearest major city to
Santo Domingo, Dominican Republic. They will then take a coach bus to Constanza.
Communal meals will be provided. Participants will be housed within 15 minutes of
project sites and may be required to share bedrooms. Men and women will be
housed separately.
Apply
Submit completed applications to a contact listed on page 5. Applications must be
received no later than 5 p.m. Central Time on Monday, September 26, 2016. One
application per person.
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Selection
On or about Friday, October 7, 2016, a random drawing will be held to select volunteers.
Volunteers will be notified by telephone or email. The odds of being selected depend on
the number of applications received from each organization.
IMPORTANT INFORMATION
Fundraising
Each volunteer is encouraged to fundraise to offset the costs of building materials,
supplies, and expenses for the mission. Lifetouch will provide fundraising ideas. No
gifts may be earmarked for a specific individual. Volunteers will comply with applicable
laws regulating the solicitation of charitable contributions. Contributions may not be
deductible under the Internal Revenue Code.
Risk
No serious accidents, illnesses, or incidents have occured on a Lifetouch Memory
Mission. Construction projects are conducted under the direction of a professional.
However, travel to and living and working at a construction site involve risk. Submitting
your name as a potential volunteer is acknowledgment that you accept the risks and will
not hold the Sponsors responsible in the event of loss, injury, or death.
Volunteers may purchase supplemental travel and medical coverage at their own expense.
Volunteers are responsible for being informed of and understanding the risks. Visit
http://travel.state.gov for travel information, tips, and warnings.
Volunteers are required to sign and return liability and publicity releases and other
required forms by Wednesday, November 2, 2016, acknowledging that risks of travel to
and work at the Memory Mission location are understood and accepted.
Health/Medical Requirements
Personal health care insurance is required and must be verified. Volunteers must have
tetanus immunization within the past 10 years. No additional immunizations are required;
however, the Centers for Disease Control and Prevention recommends that routine
vaccinations be up to date before a trip to the Dominican Republic. These vaccines
include measles, mumps, rubella (MMR) vaccine, diptheria, tetanus, pertussis vaccine,
variella (chickenpox vaccine), polio vaccine and a yearly flu shot. The CDC also
recommends Hepatitis A and typhoid, but none of these are required. Volunteers
should check with their doctors if other immunizations or medicines are recommended.
Physical Requirements
Volunteers will perform a variety of projects, including block and concrete work, stucco,
and painting. Coordinators will work with volunteers to find meaningful jobs each day.
Construction skills are not required.
Drug, Alcohol, and Tobacco Use
The use of recreational drugs, alcohol, and tobacco is prohibited from the time
volunteers arrive on January 16, 2017, until their return on January 24, 2017.
Rules for Application
All applications must be complete and legible. Applications become the property of the
Sponsors and will not be returned. The Sponsors are not responsible for late, lost, delayed,
damaged, illegible, incomplete, or misdirected applications. Limit one application per
person. Applications submitted in violation of the official rules will be void. Application
forms are available at lifetouchmemorymission.com or by calling Lifetouch at 952.826.4361.
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CONTACT INFORMATION
Educators, Administrators, and PTA members
Lifetouch Memory Mission, 11000 Viking Drive, Eden Prairie, Minnesota 55344
Telephone 952.826.5833 [email protected]
To electronically submit your application, send to lifetouchmemorymission.com
Due 5 p.m., Monday, September 26, 2016.
Lifetouch Companies
11000 Viking Drive, Eden Prairie, Minnesota 55344
Lifetouch Inc./Lifetouch Services (LTI/LSI) – Jan Gohl
telephone 952.826.4361 fax 952.826.4459 [email protected]
Lifetouch Church Directories and Portraits (LCD) – Kirsten Van Hulzen
telephone 952.826.4058 fax 952.826.4226 [email protected]
Lifetouch National School Studios/Lifetouch Canada (LNSS) – Ellen Ferry
telephone 952.826.5405 fax 952.826.4373 [email protected]
Lifetouch Preschool Portraits (LPP) – Dawn Dahlberg
telephone 952.826.4197 fax 952.826.4373 [email protected]
Lifetouch Portrait Studios (LPS) – Louise Indritz
telephone 952.826.5657 fax 952.826.4459 [email protected] Liability and Publicity
Volunteers will be required to sign valid liability/publicity releases. By accepting
participation in the 2017 Lifetouch Memory Mission, the volunteer agrees that the
Sponsors, their affiliates, officers, directors, employees, or agents, will have no liability for
any injuries, losses, or damages related to the Memory Mission. Acceptance of the volunteer
opportunity constitutes agreement by the volunteer that the Sponsors and other persons
or entities authorized by the Sponsors may use, publish, and/or display the volunteers’
names, addresses, likenesses, and testimonials in any media without limitation for any lawful
purpose without further consideration.
This Memory Mission is organized by the Sponsors. Sponsors are not responsible for delays
or inability to complete the Memory Mission due to strikes, acts of God, labor troubles,
war, terrorism, delays of commercial carriers, restraints of public authority, political unrest,
medical concerns, or for any other reason beyond its control. A list of volunteers selected
may be obtained by sending a self-addressed, stamped, business-size envelope by February
13, 2017, to Lifetouch Memory Mission at the address above. Void in Puerto Rico and where
prohibited. Taxes, if any, are the responsibility of the selected volunteers. No transfers or
substitutions, except at the discretion of a Sponsor for its respective organization. The
Memory Mission may be canceled at any time or for any reason and no compensation or
other consideration will be provided.
Additional details will be provided to volunteers selected. Volunteers and applicants agree to comply with all
applicable laws and requirements imposed by the Sponsors, even if they are not described in this document.
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VOLUNTEER APPLICATION
2017 LIFETOUCH MEMORY MISSION®
CONSTANZA, DOMINICAN REPUBLIC
Entry
Complete this application and submit to the contact listed on page 5. Applications
must be received no later than 5 p.m. Central Time on Monday, September 26, 2016. A
random drawing will take place on or about Friday, October 7, 2016. Selected volunteers
and alternates whose names are drawn will be notified by phone, mail or email.
APPLICATION DEADLINE
MONDAY, SEPTEMBER 26, 2O16
5 PM CENTRAL TIME
Submit completed application
to the contact listed on page 5.
Application
I am submitting my name for the random drawing sponsored by AASA, NAESP, NASSP,
NSBA, National PTA, and Lifetouch to volunteer for the 2017 Lifetouch Memory
Mission to Constanza, Dominican Republic. I have read, understand, and agree to
comply with the conditions of the Memory Mission as described in the 2017 Lifetouch
Memory Mission Volunteer Information and Application, including the restrictions
on drugs, alcohol, and tobacco. I agree to comply with all other requirements of
the Sponsors and applicable laws. I acknowledge and accept the risks of traveling to
and from, living, working, and volunteering at the Memory Mission location. If I am
selected, I agree to sign a valid Liability and Publicity Release. I also agree to complete
a medical information form and provide such other information as is reasonably
required. I understand that I may request and review a copy of the liability and publicity
releases through the contacts listed on page 5. Participants of past Memory Missions are
not eligible to apply.
Name of Applicant_________________________________________________________________________
School/Office______________________________________________________________________________
School/Office Address_____________________________________________________
City ___________________________ State/Province ____ ZIP/Postal Code_________
E-mail_________________________________________ Twitter @ __________________
Phone: Mobile _____________________ Home _____________________ Work ____________________
Representing (mark all that apply):
AASA
NAESP
NASSP
National PTA
NSBA
Educator
______________________________________________________________________________ _____/_____/_____
Applicant Signature
Date
______________________________________________________________________________ _____/_____/_____
Administration/Manager Signature (If Required)
FOR LIFETOUCH EMPLOYEES ONLY
Sponsoring Organization: LTI/LSI
LCD
Date
LNSS
LPP
LPS
Open to all eligible Lifetouch employees in good standing as of the date of travel
who are residents of the United States or Canada and who will be 21 years of age as of
September 26, 2016. Lifetouch employees must have been employed by Lifetouch for a
minimum of two years at the time of the mission and have supervisor approval.
_______________________________________________________________________/_____/_____
Lifetouch Manager Signature (Required)
Date
11000 Viking Drive
Eden Prairie, Minnesota 55344-7242
@LifetouchMM2017
Lifetouch Memory Mission-DR
@LifetouchGivesBack
lifetouch.com
lifetouchmemorymission.com