BARVALIPE

The 1st ROMA PRIDE SUMMER CAMP

APPLICATION FORM

Thank you for your interest in Barvalipe: The 1st Roma Pride Summer Camp. Selected participants willattend the camp in Budapest, which will last for 10 full days, including a 2-day study trip to the Auschwitzconcentration camp in Poland. Barvalipeintends to provide young Roma with a powerful experience and encourage them to choose to serve as role models, political leaders and civic activists able to advocate for themselves and their communities. Participants will explore the roots and future of Roma identity in a learning environment with distinguished Roma professors and civil leaders.

As mentioned in the call for applications, there are no special selection criteria. There are 15places available at the camp on a first come, first served basis. Participation will be offered to the first individuals who submit full applications.

Please note thatan application is only considered to be a full application when all of the requested documents mentioned in the call and listed below are submitted.

Requested documents:

  • Completed application form (see below)
  • Essay of approximately 500 words explaining the candidate's expectations from the camp and motivation for applying.
  • CV (The Europass CV template can be downloaded at:

Application Deadline:June 22, 2011

Personal Information

Given/First Name:

Family/Last Name:

Date of Birth:

Place of Birth:

Gender:

Marital status:

Mailing address:

Telephone:

E-mail address:

Program/s I participate/d supported by Open Society Roma Initiatives:

Passport information:Passport number:

Date and Place of issue:

Expiration date:

Please indicate here if you need a visa:

Contribution fee:

I hereby confirm that I will pay 20 Euro contributionfee once I arrive at the camp.

Getting to know you

Barvalipe:The 1stRoma Pride Summer Camp will give you the opportunity to interact with many other young Roma people from Central and Eastern Europe. Participants will come from different countries as well asfrom different culturaland educational backgrounds. The questions below will give us the opportunity to shape the program according to your answers and experience. Furthermore, they will help give you an insight into your own ethnic identity.

I.Some applicants might not have had prior civil society experience, while others have had many opportunities for involvement. If you have participated in any Roma-relatedor other civic activities—youthgroups, summer camps, volunteer opportunities or others, please list them here:

1.

2.

3.

4.

5.

6.

II. Identity is a complex issue and it can be described from many different aspects. Describe your own identity. What are the most important things you do in your life as a result of being who you are? What things define you as who you are?

III. Did you have the opportunityto learn Roma language? If yes, please describe where. If not, please give the reasons.

IV. Do any of your parents speak Romanes? If so, who?

V. What is the language spoken in your family?

VI. Did you have the opportunity to learn Roma history? If yes, please describe where. If not, please give the reasons.

VII. Which of the following characteristics do you feel describe your affiliation with the Roma ethnic group? (Please underline and describe.)

  • Language:
  • Traditions and culture:
  • Music:
  • Food:
  • Clothes:
  • Set of values. Please list them:
  • The experience of stigmatization, discrimination and exclusion:
  • Other characteristics. Please list them:

VIII. Describe a time when you hid or decided not to affirm your Roma identity in a public or social setting. Why did you choose to do so?

IX. Describe a time when you affirmed your Roma identity in a public or social setting. Why did you choose to do so?

VIII. Please complete each of the statements below:

  1. Most people think that I am (Roma or non-Roma)______
  2. I am proud of being Roma because______
  3. There were times when I was ashamed to be Roma because______

Use the numbers below to indicate how much you agree or disagree with each statement.

(4) Strongly agree (3) Agree (2) Disagree (1) Strongly disagree

  1. I have spent time trying to find out more about my ethnic group, such as traditions and customs.
  1. I am active in organizations or social groups that include mostly members of my own ethnic group.
  1. I have a clear sense of my ethnic background and what it means for me.
  1. I think a lot about how my life will be affected by my ethnic group membership.
  1. I am happy that I am a member of the Roma minority I belong to.
  1. I have a strong sense of belonging to my own ethnic group.
  1. I understand pretty well what my ethnic group membership means to me.
  1. In order to learn more about my ethnic background, I have often talked to other people about my ethnic group.
  1. I have a lot of pride in my ethnic group.
  1. I participate in cultural practices of my own group, such as special food, music or customs.
  1. I feel a strong attachment towards my own ethnic group.
  1. I feel good about my cultural or ethnic background.

______

Date Signature

Please send your application by June 22, 2011 to:

E-mail: Fax: +36 1 882 3841

Please include “Barvalipe: The 1stRoma Pride Summer Camp” in the subject of your message.