Tilmelding * Enrolment * Inscription * BOLIVIA

TILMELDINGSFORMULAR * ENROLMENT FORM * FICHE D'INSCRIPTION

	BOLIVIA
	Please fill out in Spanish or English and press the "SUBMIT" button at the bottom of this page. For volunteering enrolments send a mail to info@exis.org with your CV and a personal letter of motivation explaining why you are interested in working as a volunteer and stating any previous experience.
Dato:
Nombre/First name:
Apellido/Last name:
Dirección/Address:
Country:
Téléfono/Telephone:
E-mail:
Nationality:
Occupation:
Formación/Education:
Edad/Age/Birth date:

Calificaciones/Special qualifications:

How long have you studied Spanish?	years months

Knowledge of other languages?	language years
	language years
	language years

When can you start?

Spanish course:	I would like to follow Spanish lessons for
	weeks (minimum 2 weeks)

Voluntary work:	I would like to do full time volunteer work after my spanish course for
	weeks (minimum 2 weeks)

Priorities	Please give 3 priorities:
	Nursery home for poor children
	Center with after school activities
	Culture foundation center
	Kindergarten 1
	Kindergarten 2
	Kindergarten for handicapped children
	Adult psychiatric hospital
	Hospital/orphanage for handicapped children
	Orphanage for babies
	Day-care center
	Hogar Mallorca
	National Park
	Jungle experience


Accomodation	Which accomodation do you prefer during voluntary work?
	Family
	Apartment

Do you smoke?	Yes, I smoke
	No, I don't smoke

Insurance?	Do you want EXIS to provide travel insurance?
	Yes
	No
Whom to contact in case of illness etc.

Apellido, nombre / Surname, first name

Dirección/Address

Téléfono/Telephone

E-mail:

Eventuelle bemærkninger: Comments:

Hvordan kom du i forbindelse med Exis? How did you find Exis?

		For volunteering enrolments please add a CV and a personal letter of motivation explaining why you are interested in working as a volunteer and stating any previous experience.