Tilmelding * Enrolment * Inscription * TANZANIA

TILMELDINGSFORMULAR * ENROLMENT FORM * FICHE D'INSCRIPTION

	Community Service Programme Kenya
	Please fill out in English and press the SEND 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:	How lmany weeks do you want to volunteer?
	3 weeks
	4 weeks
	5 weeks
	6 weeks
	7 weeks
	8 weeks
	9 weeks
	10 weeks
	11 weeks
	12 weeks

Voluntary work preference:	Which type of volunteer work would you like to do? Please type in the number in order of preference (1,2,3) in the first colum and tick off the squares of your choice in the second column.

	Teaching English
	Teaching computer skills
	Teaching arts and crafts
	Work at an orphanage
	HIV/AIDS projects
	Music School

Travel together?	Do you wish to travel together with a friend?
	yes
	no

	If you want to travel with a friend, please state his/her name:


Address of parents in case of emergency:

Names:

Address:

Telephone:

E-mail:

Comments:

How did you find Exis?


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