The Immigrant Workers Freedom Ride

Application to Participate in the
New American Freedom Summer

Name:
Dates available:
Organization:
Union/University:

Address (Permanent):
City :
State:
Zip:

Address (Temporary):
City:
State:
Zip:

Phone:
Cell:
Email:

Do you have a car?	Yes No
Do you have a valid drivers license?	Yes No
Spanish Proficiency:	Fluent Conversational Minimal None
Creole Proficiency:	Fluent Conversational Minimal None
Location Preference:	Arizona Florida None

1: Did you participate in the 2003 Immigrant Workers Freedom Ride? If yes, in what capacity?

2: Why do you want to participate in the New American Freedom Summer?

3: What do you hope to bring back to your organization/community after participating in the NAFS?

4: What experiences in your own life make you want to work for social justice and civic participation among immigrants?

5: you have any experience in or knowledge of Caribbean and/or Latino communities?


Please provide contact information for two references:
Reference1:
Name:
Organization:
Phone:
Email:

Reference 2:
Name:
Organization:
Phone:
Email: