Church Outreach To Youth Project, Inc. 64 Marshall St. P.O. Box 745 North Adams, MA 01247
Tele: (413) 346-3241 email: cotyproject@gmail.com www.cotyproject.org
Haiti Plunge Recommendation Form
2011 - 2012
Please type or print
Name of Applicant_______________________________________________________
( 3 ) recommendations from the following:
Circle the category that you represent:
- Parent
- Clergy/ Guidance Counselor
- Adult Friend ( over 30 )
How long have you known the applicant___________
1. The Haiti Plunge is a cross cultural immersion program that requires its team
members to live simply. They will share a dormitory with bunk beds, eat simply,
and live without running water or electricity. For 10 – 14 days they will be
challenged to live a community lifestyle with their team. They must be capable of
living in a remote village set deep within the Haitian bush. In light of this
information detail the strengths and weaknesses of this applicant.
2. Less than one percent of the student population in the USA has the opportunity to
experience this type of program. The Plunge places great emphasis on leadership
development. What pronounced leadership qualities does this applicant exhibit?
3. Given your relationship with the individual what do you perceive to be the most
challenging aspect of this experience for the applicant?
4. Additional comments.
Please print your name:________________________
Your signature: _______________________ Date:_____________________
Please place in a sealed envelope and return to the applicant who will submit it with their
application packet.
Mailing address: COTY / Haiti Plunge
P.O. Box 745
North Adams, MA 01247