Volunteer Application Form:

SEEDS Voluntourism Trip To Zambia

About You

Title *

Please select

Mr

Mrs

Miss

Ms

Dr

Full Name *______

Postal address *______

Country *______

Phone number (including country code) *______

E-mail *______

Do we have your permission to pass on your e-mail address to other volunteers? *

Please select

Yes

No

Volunteers find it useful to be put in contact with past, present or future volunteers prior to the start of their placement.

Date of birth *______

Volunteer area of interest *

Please select

Carpentry

Plumbing

Cooking

Children’s Education

Computer skills

Healthcare

Environment

Animal Husbandry

Agriculture

Team leader

Mixture of the above

Healthcare professionals: Please note that we will need photocopies or scanned copies of your qualifications.

Ideal dates for traveling with SEEDS to Zambia *______

Preferred number of weeks *______

How flexible are you regarding these dates? *______

Very flexible, fairly flexible, or not at all flexible? Please give us as much information as possible as it will help us to plan our volunteer schedule.

Are you aware of the amount of money you will have to pay to volunteer with SEEDS in Zambia? *

Yes or No. If No, please go to the "Costs to Volunteer" page on the website to make sure you know how much you will have to pay before you submit this form.

The Nitty Gritty

Reason(s) for wanting to volunteer *______

Previous education, employment, and work/travel *______

Experience overseas *______

Personal interests *______

Future plans *______

What are your strengths? *______

What are your weaknesses? *______

Why do you think you will make a good volunteer? *______

Based on the information you have read on the SEEDS website, how in particular do you think you could proactively contribute to the community development in Zambia by volunteering with SEEDS? *______

Proactive, "ideas" type people tend to get the most benefit from the volunteering program.

Any other relevant information

References

How did you hear about volunteering with SEEDS?

*______

Please give the name, address, and e-mail of one professional referee and one personal referee *______

Your professional referee must have worked with you for at least one year. It would also be helpful to know your relationship to your professional referee.

Your personal referee must have known you for at least five years and cannot a member of your immediate family. It would also be helpful to know your relationship to your personal referee.

Emergency Contact

Emergency contact details *______

Please give us the name, address, phone number, e-mail address, and relationship to you (i.e. mother, father, etc.) of the person who should be contacted in the event of an emergency.