Tilmelding * Enrolment * Inscription * CAMBODIA

TILMELDINGSFORMULAR * ENROLMENT FORM * FICHE D'INSCRIPTION

	Cambodia Individual volunteer package program
	Please fill out in English and press the SUBMIT button at the bottom of this page. Please also remember to 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, including a picture - and stating any previous experience.
Date:
First name:	According to passport
Last name:	According to passport
Full address:
Country:
Telephone:
Mobile phone:
E-mail:
Skype:
Nationality:
Passport number:
Education/Profession:
Birth date:

Languages spoken:	language years
	language years
	language years

How long have you studied English?	years months

Work experience:

Do you smoke?	yes
	no

Are you under any medical treatment, if yes, please specify!

Do you have any dietary restrictions ?	yes
	no
If yes, please specify:

Expected arrival date: (When do you want to start the programme?).-	(Day, month, year)

Duration voluntary work:	For how long do you want to start the programme?



Voluntary work choice:	Which type of volunteer work would you like to do?
	Orphanage or school
	Teaching English or IT
	PADV
	Legal Aid/Human Rights
	Health/Medicine
	Environment
	Architecture/Social Engineering/Town Planning
	Nursing

Whom to contact in case of emergency (i.e. parents):

Names:

Address:

Telephone:

E-mail:

Comments:

How did you find Exis?


		Remember to e-mail the following document : Letter of motivation, stating why you would like to volunteer and if you have any relevant experience or personal interests.