BIENVENIDO

PASO 1. Llena la solicitud en internet www.olestaff.org

PASO 2. Colecta y envía los documentos que se enlistan a continuación. Puedes enviarlos por email en

primera instancia, pero deberás entregarlos físicamente el día de tu entrevista o enviarlos por correo

postal como se indica al final de este documento.

PARA SOLICITAR ENTREVISTA: Una vez que hayas llenado tu solicitud en internet. Puedes solicitar

entrevista escribiendo a info@olestaff.org.

ESTA ES LA LISTA DE FORMATOS O DOCUMENTOS QUE DEBERÁS DE ENTREGAR:

(Las cartas de recomendación, referencias, carta de no antecedentes penales, etc. deben de estar en

inglés o traducción al inglés. La traducción no necesita estar firmada ni sellada ni en membrete)

1. COPIA DE IDENTIFICACIÓN OFICIAL. Por ambos lados 2. COPIA DE COMPROBANTE DOMICILIARIO (no mayor a 3 meses de antigüedad) 3. MEDICAL FORM. Aquí se incluye el formato páginas 3 a 5.

4. PROOF OF STUDENT STATUS. Aquí se incluye el formato en la página 6, puedes usar este

formato o bien puedes usar una constancia de estudios o carta oficial de tu escuela en su lugar.

5. PARTICIPANT REFERENCE FORM. Aquí se incluye el formato en la página 7 este debe ser llenado por un profesor, supervisor, jefe o exjefe. No debe ser la misma persona que llene la carta de recomendación. (Por favor asegura que todo esté bien llenado y se especifique el puesto y la institución o empresa de la persona que llena esta referencia. Debe de llenarse en inglés) (Puedes utilizar en lugar de estas referencias, los formatos digitales que vienen en la solicitud en internet.)

6. DOS CARTAS DE RECOMENDACIÓN No existe un formato específico. Solo es una carta de recomendación en hoja membretada, firmada y fechada y de ser posible sellada. (Si la carta no puede

ser en hoja membretada, es necesario entonces contenga sello o tarjeta de presentación de la persona que recomienda).

Asegúrate de que esta carta contemple lo siguiente: - Debe de ser de algún profesor, director, coordinador, supervisor, jefe, exjefe o ex profesor. (No

familiares o amigos) - Que la carta indique cual es la relación de la persona contigo, es decir, que especifique si es o

fue tu jefe, exjefe, maestro, etc. - Que contenga datos de contacto de quien te recomienda.

7. TERMS AND CONDITIONS Aquí se incluye el formato páginas 8, 9 8. CURRICULUM VITAE EN INGLÉS. Aquí se incluye un ejemplo en la página 10 (No es necesario

hacerlo exactamente de acuerdo a este ejemplo, puedes utilizar otro formato)

9. COPIA DE PASAPORTE. Solamente copia de la página de foto y datos, no importa que este vencido.

10. CARTA DE NO ANTECEDENTES PENALES (POLICE BACKGROUND CHECK). Carta emitida por el departamento de Justicia Federal o Estatal en donde se hace constar que no se tienen antecedentes penales. (O en caso de tenerlos se explica cuales son ahí mismo).

Cualquier duda o problema que tengas por favor comunícate con nosotros por email o por teléfono.

Puedes enviar tus documentos escaneados por correo electrónico, y enviar posteriormente los originales a (Esta dirección es solamente para entrega de documentos ya sea en persona o por mensajería) “Ole Staff” Circuito Interior Juan Pablo II 3302 Local 5 Col. Las Ánimas, Puebla, Pue. Mexico 72400

1 Health History and Examination form for children, youth and Adults attending camps

(To be completed by the applicant)

The information on this form is not part of the camper or staff acceptance process, but it’s gathered to assist us in identifying appropriate care.

Last Name First Name Birth date (mm/dd/yyyy) Age at camp

Home address: City: State Zip

Social security number (if any) _____________________________________________ Gender: Male _____ Female _____ Email address:_________________________________________________________ Phone: ___________________________________ Emergency contact #1: __________________________________________________ Relationship to applicant: ____________________ Email address:_________________________________________________________ Phone: ___________________________________ Emergency contact #2: __________________________________________________ Relationship to applicant: ____________________ Email address:_________________________________________________________ Phone: ___________________________________ Insurance Information

Is the participant covered by family medical/hospital insurance? Yes __________ No ___________ If so, indicate carrier or plan name: __________________________________________ Policy: _________________________ (Photocopy of front and back of health insurance must be attached to this form)

HEALTH HISTORY

(Check all that apply)

Anemia Dizziness/Fainting Heart Disease Mumps

Anorexia Ear infection Hepatitis A/B/C Pregnancy

Arthritis Epilepsy/ Seizures Kidney Disease Rheumatic Fever

Asthma Eye Problems Malaria Scarlet Fever

Bulimia Gallbladder Problems Measles Tuberculosis

Chicken pox German Measles Menstrual Problems Ulcers

Depression Glandular fever Migraine /headaches Venereal Disease

Diabetes Other: If you check any of the above, please give details (including dates) on a separate sheet of paper

Place a check mark next to following organs or systems if there any known abnormalities?

Cardiovascular Head, ears, nose, throat Reproductive Metabolic

Respiratory Skin Eyes (including glasses or contacts) Gastrointestinal

Genitourinary Musculoskeletal Nervous Other If you check any of the above, please give details (including dates) on a separate sheet of paper

Do you suffer from any allergies?

Allergies: Describe reaction: Management or treatment:

Hay Fever

Insect Sting

Penicillin

Other drugs

Food

Other

Medications being taken

Please list all medications taken routinely. Bring medication to last the entire time at camp. Keep it in original packing/bottle that identifies it.

This person takes NO medication on a routine basis

This Person takes medication as follows: Med#1____________________________ Dosage: _____________________ Specific times taken each day___________ Reason por taking __________________________________________________________________________________ Med#2____________________________ Dosage: _____________________ Specific times taken each day___________ Reason por taking __________________________________________________________________________________ Attach additional pages for more medications

2 Health History and Examination form for children, youth and Adults attending camps

RESTRICTIONS

The following restrictions apply to this individual

Does not eat red meat Does not eat pork Does not eat eggs

Does not eat poultry Does not eat seafood Does not eat dairy products

Other (describe):

Explain any restrictions to activity (e.g. what cannot be done, what adaptations or limitations are necessary)

GENERAL QUESTIONS Has/does the participant: Yes No Yes No 1. Had any recent injury, illness or infectious

disease? 17. Ever had problems with joints (knees, ankles)?

2. Have a chronic or recurring illness/condition? 18. Have an orthodontic appliance being brought at camp?

3. Ever been hospitalized? 19. Have any skin problems? 4. Ever had surgery? 20. Have diabetes? 5. Ever been knocked unconscious? 21. Have asthma? 6. Wear glasses, contacts? 22. Have mononucleosis in the past 12 months 7. Ever had frequent ear infections? 23. Had problems with diarrhea/constipation? 8. Ever passed out during or after exercise? 24. Had problems with sleepwalking 9. Ever been dizzy during or after exercise? 25. If female, have an abnormal menstrual history? 10. Ever had seizures? 26. Have a history of bed-wetting? 11. Ever had chest pain during or after exercise? 27. Ever had an eating disorder? 12. Ever had a head injury? 28. Ever had emotional difficulties for which

professional help was sought?

13. Have frequent headaches?

14. Ever had high blood pressure?

15. Ever been diagnosed with a heart murmur?

16. Ever had back problems?

Please explain any “yes” answer, noting the number of questions

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Please check whether the applicant had been immunized against the following and provide date of immunization

Chicken pox (varicella) Date:

Hepatitis B Date:

TP Mantoux test Date:

Diphtheria Date:

Haemophilus Influenzae B Date:

Tetanus Date:

Mumps Date:

Typhoid Date:

German Measles (rubella) Date:

Measles Date:

Polio Date:

Whooping Cough Date:

Use this space to provide any additional information about the participant´s behavior and physical, emotional or mental

health about which the camp should be aware

__________________________________________________________________________________________________

__________________________________________________________________________________________________

I certify that all information given is true to the best of my knowledge, and I hereby give permission for emergency

medical care should it be necessary

Signature ____________________________________________________ Date (mm/dd/yyyy) ____________________

3 Health History and Examination form for children, youth and Adults attending camps

(To be completed by the doctor)

Last Name First Name Day of examination (mm/dd/YYYY)

BP (blood pressure) _________________ Height _______________ (in feet and inches) Weight______________ (in pounds)

In my opinion the above applicant IS IS NOT able to participate in an active camp program

The applicant is under the care of a physician for the following conditions:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Recommendations and Restrictions at camp:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Treatment to be continued at camp:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Medications to be administered at camp (name, dosage, frequency):

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Any medically prescribed meal plan or dietary restrictions:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Known allergies:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Description of any limitation or restriction on camp activities:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Additional information for health care staff at the camp:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Signature of licensed Medical Personnel: ________________________________________________________________ (Firma y nombre completo del doctor)

Title: _____________________________________________________________________________________________

(Titulo y cedula profesional)

Adress: ___________________________________________________________________________________________

(Dirección)

Phone: _______________________________ Email:______________________________ Date:____________________

(Stamp/sello)

J1 Participant Character Reference

The person named below has made an application for sponsorship in the Exchange Visitor Program and is kindly

requesting you provide a character reference on their behalf. We appreciate your help in the screening of the applicant.

Their application and acceptance in the program is dependent on you completing this reference

Last Name:_____________________________________________ First Name: _____________________________

Position applying for: ____________________________________

Please complete the following information to the best of your knowledge

High Above Average Average Low

Communication Skills

Maturity compared with peers

Overall Health , energy and endurance

Leadership skill

Ability to get along with others

Sense of humor

Ability to adapt to new situations

Ability to handle difficult situations

Ability to accept responsibility

Has the participant ever been investigated for allegations of child abuse? Yes__ No __

Has the participant ever been convicted of a crime? Yes__ No __

Is there any reason you are aware that this person should not work with children? Yes__ No__

Would you hire this person to work with child of your own Yes__ No __

Please use the space below to provide comment on the applicant's suitability for employment

Your Name: ______________________________________________________________________

Position/Organization: _____________________________________________________________

Email address: __________________________________ Phone:___________________________

How long have you known the participant: _____________________________________________

What is your relationship with the participant: __________________________________________ (e.g. English teacher, Supervisor, etc) I verify that the information on this reference accurately represents the applicant and is true to the best of my knowledge. Signature:_____________________________________________ Date: (mm/dd/yyy)_______________________

2014 Ole-Life Adventures Participant Agreement

Required Procedures and Documentation. Participant agrees to follow all required procedures and submit to Ole -

Ole-Life Adventures all required documentation.

• Submit all the documents required in the Formats Instructions

• Complete the submission of this application packet

• Pay a $35 SEVIS fee

• Pay a $190 Program fee which includes the U.S. Embassy fee to get the Visa.

Program Rules. Participant agrees to abide at all times to the all rules set forth by the US Government pertaining to J-

1 Exchange Visitor Programs.

Behavior While On Program. Participant will conduct him/herself in a professional manner on the job and abide by all

US and local laws while on the program. Further, Participant agrees to fulfill all terms and conditions as set forth in

his/her employment agreement.

Passport. Participant is required to report to Ole-Life Adventures any changes to or renewal of Participant's his/her

offer of employment.

Cross-Cultural Activities. Participant agrees to be active in getting involved in company and local events in order to

foster cultural exchange. These activities include, but are not limited to, company gatherings, local sporting events,

community seasonal festivals and events.

Program Termination. Should Participant decide to leave his/her job for any reason and/or should Participant be

terminated from a position, Participant must immediately contact the sponsor indicated in his/her visa and DS2019

form. Participant must have on hand at all times the numbers and contact info provided by Ole.

Change of housing/contact info. Participant is required to inform Ole-Life Adventures should any housing or contact

information change at any point during the program. Changes are required to be in writing and may be submitted to

Ole-Life Adventures through www.lifeadventures.us or by emailing info@lifeadventures.us.

Applying for US Social Security Number. Within the first two weeks in the US, Participant will apply for a US Social

Security number. Participant should ask the employers assistance to get to the Social Security office. In the event tat

the employer does not provide the necessary assistance to do so, participant must inform immediately to Ole-Life

Adventures

Active Email. Participant must have an active email on file with Ole-Life Adventures for ease of communication.

Participant should also call or email Ole Life Adventures within the next 5 days after they arrive to camp to let know

they are at camp.

Flight Itinerary. Flight information must be faxed or emailed to Ole-Life Adventures at least 15 days prior to departing

home country.

Participant Name: _______________________________

Participant Signature: _____________________________ Date:___________________

2014 Ole-Life Adventures Terms and Conditions

1. Fees. SEVIS and VISA fees and VISA must be paid before going to the embassy to apply for a J1 VISA.

Any other expenses are explained to participant directly so he/she understands all costs involved.

2. Program Fee of $190. Must be paid in advanced, upon acceptance in the program, so the participant

is able to be scheduled to assist to a U.S. consulate in a group appointment, as required by the

Embassy.

3. Passport. Participant must have a valid passport with an expiration date at least until December

2014.

4. Medical Insurance. Ole-Life Adventures provides the required insurance coverage.

5. Flights. Participant must purchase roundtrip airfare to and from the U.S. Participant must provide

Ole-Life Adventures with copies of the flight itinerary and receipt prior to departure to US.

6. Paperwork and Documentation. Participant must complete all required paperwork and

documentation in a timely manner. Failure to provide Ole-Life Adventures with information may

result in delay or termination of his/her program.

7. Cancellations and Refunds. After interview, the accepted participant must cover the Program fee. In

case the participant cancels or withdraws from the program prior to June 1st of 2014, for any

reasons, the participant must cover the fee of $150usd. In the case of a Visa Denial the Participant

must provide proof of denial to Ole-Life Adventures and return the DS2019. If a participant is not

offered a job after June 1st he/she can withdraw from the program and receive a full reimbursement

of Program fee.

8. Employment Time. Participant agrees that the minimum work time on the program will be three

weeks and the maximum will be four months.

9. Post Employment Travels. Participant must return to his/her home country. At the end of the

Participant's employment term, he/she may travel the U.S. for a maximum of 30 days before

returning home if the school schedule allows. During this time the Participant may not leave and

then return to the U.S., unless the Participant's DS-2019 has been signed by sponsor official.

Participants wishing to leave and then return to the U.S. should call Ole-Life Adventures at least 2

weeks prior to leaving the U.S. so that Ole-Life Adventures may clearly explain the rules and

regulations regarding traveling.

Participant Name: _______________________________

Participant Signature: _____________________________ Date:___________________

CURRICULUM VITAE Objective: Apply for a support staff position, helping in the kitchen preferable. Available from _(date you can start working)_ until _(last day you can stay in the camp).

Name: Alessandra Villanueva Martinez Address: Priv. Chs # 5 Col. Aredas Cholula, Puebla. México Postal Code 760 Email miauchis@yahoo.com Telephone: +52 (222) 232-1456. Cell Phone +52-1-2223-123-456 Nationality: Mexican Date of Birth : January 1st, 1988 Marital Status: Single

Educational Qualifications: Aug 2007- Currently UGP (Universidad Gastronómica De puebla) Culinary Student. 5th Semester 2001 to 2004 Colegio Pola- Puebla, Pue. High-School Diploma with specialty in Electricity Employment to Date:

June 8 to Aug 18, 2007 Arteas Hotel, Cancún Quintana Roo Tel. (313) 4257608 Cook (Pantry for 800 people)

June 8 to Aug 17, 2006 Archimini Restaurant, Queretaro, Queretaro. Tel. (243) 123-456 Cook (Pantry and Bakery for 380 people ) Italian Food

Nov 14, 2004 to March 20, 2005 ZARA store. S.A. de C.V As a cashier and public service

April 15 to April 20, 2005 Watuzi Watoto Camps in Africam Safari, (222) 123-456 as a counselor. (Puebla, Mexico)

Other Studies and Activities

Course on Chocolatiere. June, 2007

Attach a Digital

PHOTO Here.

(Smile)

Universidad de las Americas Puebla 300 hours duration.

Hobbies and Interests

Guitar: Play acoustic and electric since 1992.

Soccer. Play since 1987. Member of the University Team. Took classes from 1995 to 2000 in the Puebla FC.

Spoken Languages. Spanish … Native English 90% spoken, 80%Written, 100% Read. Currently taking TOEFL courses. French 20%. Currently taking classes in basic level.