TILMELDINGSFORMULAR * ENROLMENT FORM * FICHE D'INSCRIPTION
 
COSTA RICA
 

Tilmeldingsformular - Enrolment Form - Fiche d'inscription EXIS

 

Please fill out in Spanish or English and press the "SEND" button at the bottom of this page.

For voluntary work enrolments send a mail to info@exis.org with your CV and a personal letter of motivation with picture 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?
   
Language course:
I would like to follow spanish lessons during
  2 semenas weeks
  4 semenas weeks
  6 semenas weeks
  8 semenas weeks
  10 semenas weeks
   
Voluntary work: Prefiero trabajar como voluntario con - I would like to work as a volunteer with:
  Programa A - trabajo social y otros trabajos voluntarios
      / social work and other voluntary work
  Programa B - parques nacionales / national parks
   
Program A: Program A: Length of voluntary social work:
  4 semenas weeks
  6 semenas weeks
  8 semenas weeks
  10 semenas weeks
  12 semenas weeks
   
Program A: Para programa A, por favor, escoger tres de las posilidades singuientes según sus prioridades. In programme A, please select three of the following options according to your priorities.
  A1 Centro Educativo de Educación Prioritaria Itiquís
  A2 Patronato Nacional de la infancia Naranjo
  A3 Hogar Magdala
  A4 Escuela San Luis
  A5 Centro educativo Santo Domingo
  A6 Escuela Nacional de Rehabitacion
  A7 Hogar de Ancianos Santiago Carrillos
  A8 Hogar de Ancianos Santiago Crespo
  A9 Central Library of the National University
  A10 Escuela de Enseñanza Especial (Alajuela)
  A11 Centro Educativo San Gabriel
  A12 Hospital Nacional de Niños San José
  A13 Fundación Servio Flores Alajuela
  A14 Escuela Jesús Magdalena de Cacao
   
Program B: Program B: Length of voluntary work in National Park
  1 semena week
  2 semenas weeks
  3 semenas weeks
  4 semenas weeks
   
  Parque Nacional
   
Do you smoke? yes
  no
   
Pårørende der bedes underrettet i tilfælde af sygdom o. lign.
Who 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?
   
Remember to send us your CV and letter of motivation   For voluntary work enrolments please add a CV with picture and a personal letter of motivation explaining why you are interested in working as a volunteer and stating any previous experience.