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					          Peace Revolution
          Application for Peace Revolution Internship program

1. Name of Applicant

2. Nationality                                                     3. Date of Birth

4. Present University or Institutional affiliation

5. Area of interest for internship

6. Requested dates for Internship from:                                   to:

7. Statement of understanding of the conditions of the Internship

   I understand that, should I be accepted as an intern at Peace Revolution, the following conditions will apply:

   a) I agree with and will follow the principles guiding Peace Revolution, including:

      • keeping the Five Precepts during my internship
      • behaving appropriately at all times while on temple ground
      • willingness to interact with participants from different religions and cultures
      • openness to explore topics relating to peace from a variety of viewpoints.

   b) Medical Health and Travel Insurance: Peace Revolution accepts no responsibility for costs or fatality
      arising from illness or accidents incurred during the internship; therefore, I must carry travel insurance
      for the period of internship. I will provide Peace Revolution with proof of my insurance cover.

   c) Passports and Visas: I am responsible for obtaining necessary passport and visas when required. Peace
      Revolution will issue only a letter stating acceptance of an individual as an intern and the conditions
      governing the internship.

   d) Confidentiality and Publication of Information: As an intern, I will respect the confidentiality of
      information that I collect or am exposed to at Peace Revolution. I acknowledge and agree that the
      photographs, electronic images, video, and/or audio records of me and my participation during the
      Peace Revolution Conference will be owned by Peace Revolution and that these may be used for
      promotional, educational or other non-commercial purposes to benefit Peace Revolution without my
      further consent being necessary.

Signed:                                                 Date:

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