Application Form for Ics National Volunteers

APPLICATION FORM FOR ICS NATIONAL VOLUNTEERS

(VSO MALAWI)

Completeandreturnthisformto:.

Completing andreturningthisformdoesnotcommityoutotakingpartintheICSprogramme.MakesureyouhavereadthroughalloftheenclosedinformationonICSbeforecompletingthisform.

ENSUREYOUANSWERALLQUESTIONS.INCOMPLETEFORMSWILLNOTBECONSIDERED

PERSONALDETAILS

Surname
First Name
Nationality
Date of birth (Day/Month/Year)
Age
Sex (Male/Female)
Marital Status
Your ID number
Where do you live (nearest town)
Physical address to your home
Mailing address
Email
Telephone/mobile number

NEXTOF KINDETAILS

Name
Relationship to you
Telephone number
Physical address

EMERGENCY CONTACT DETAILS (These should be the details of the person we will contact in case of an emergency. Please note that they should either be your family members or guardian. Give two contact details.

Emergency contact 1
Name
Relationship to you
Telephone/mobile number
Email address
Physical Address
Emergency contact 2
Name
Relationship to you
Telephone/mobile number
Email address
Physical Address

2. KINDLY GIVE 3 REASONS WHY YOU ARE INTERESTED IN TAKING PART IN THE ICS PROGRAMME?

3. PLEASEGIVEDETAILSOF WHATYOUARECURRENTLYDOING(Includenameandlocationof organizationif youarewithanorganization/company)

4. AREYOUINVOLVEDINVOLUNTEERINGWORKINTHECOMMUNITY?HOWOFTEN?PLEASEGIVE A BRIEFONWHEREYOUVOLUNTEER,YOURROLESAND RESPONSIBILITIES

(Pleasecontinueon separatesheetifnecessary)

Volunteer / Dates / Keyresponsibilities

5. PLEASEGIVEBRIEFDETAILSOF YOUREDUCATIONBACKGROUND(Pleasecontinue onseparatesheet ifnecessary)

School / Dates / Area of Study

6. PLEASEGIVEBRIEFDETAILSOFYOUREMPLOYMENTHISTORY

(Pleasecontinueon separatesheetifnecessary)

Employment / Dates / Keyresponsibilities

7. SUPPORT/ADDITIONALREQUIREMENTS

ICS is an inclusive programme committed to increasing participation of young people of all abilities.

Do you consider yourself to be a person with disability?(Ifyes,pleaseindicatethetypeof disability and any adjustmentsyouwouldlike ICS to makeforyouaccordingto thetypeof disabilityyouhave)

8. REFEREES

Pleasegivethenamesand addressesof tworeferees.Thefirst refereeshouldbe ableto commentonyourskillsandshould besomeonewhohasstudied, worked,volunteeredortrainedwithyou.Thesecondshould besomeonewhohasknown you wellforat leasttwoyears,suchasa friend.Your refereesshouldnot berelatedto you.

FIRST REFEREE- Professional

Name:

Telephone:

Email:

SECONDREFEREE–Personal

Name:

Telephone:

Email:

9.DECLARATION:

Signingthisdoes notcommityoutotakepart.

ItshowsthattheinformationiscorrectandthatyouwouldliketobeconsideredforaplaceonanAssessmentDay.

Allof theaboveinformationis,tomyknowledge,trueandaccurate.

Signed:Date

VSO will storeandprocessyourdatainaccordancewiththerequirementsofitsData ProtectionPolicyandinkeepingwiththeDataProtectionAct1998. VSOmayuseyourdetailstosend youfurtherinformationrelating totheirinternationaldevelopmentwork.