Individual Volunteer Application.

Thank you for your interest in volunteering with IVN. Please fill the form below, providing as much information as possible. Note: This form is also available in pdf.
Click Here for PDF Version.

You must provide the information for fields indicated by ***.

*** Name:
Other Names:
Date of birth:	DD: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM: January February March April May June July August September October November December Year:
Gender:	Male    Female
Nationality:	Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep Chad Chile China Cocos Islands Colombia Comoros Congo, Dem Republic Congo, Republic of Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Cyprus (North) Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong (China) Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau (China) Macedonia (FYR) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Northern Mariana Is Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia St Vincent Grenadines Samoa Sao Tome Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan (ROC) Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad Tobago Tunisia Turkey Turkmenistan Turks Caicos Is Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Is (British) Virgin Is (US) Wallis Futuna Is Yemen Yugoslavia Zambia Zimbabwe
Mailing address:
State (US Residents):
Post/Zip code:
*** Country:	Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep Chad Chile China Cocos Islands Colombia Comoros Congo, Dem Republic Congo, Republic of Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Cyprus (North) Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong (China) Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau (China) Macedonia (FYR) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Northern Mariana Is Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia St Vincent Grenadines Samoa Sao Tome Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan (ROC) Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad Tobago Tunisia Turkey Turkmenistan Turks Caicos Is Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Is (British) Virgin Is (US) Wallis Futuna Is Yemen Yugoslavia Zambia Zimbabwe
Phone (home):
Phone (work):
Fax:
*** Email address (please check):
Alternate email address:
Highest qualification:	High School Graduate Undergraduate First Degree Graduate Second Degree/Masters Graduate Other
Other relevant qualifications and skills:
Work and travel experience:
Please state any health condition that you have, including allergies (it is important for us to be aware of any condition so we can be prepared in placing you):
*** Do you have a religious background? (Please specify)
How long would you like to volunteer for?	2 Weeks 4 Weeks 6 Weeks 2 Months 3 Months 4 Months 5 Months 6 Months
*** When will you arrive in Uganda ?	MM: January February March April May June July August September October November December YY: 2009 2010 2011 2012
What volunteer program are you most interested in?	Family Empowerment Primary Health Care HIV/AIDS Prevention & Couselling Child Education / Vocational Training Community Develoment / Building
What is your second choice?	Family Empowerment Primary Health Care HIV/AIDS Prevention & Couselling Child Education / Vocational Training Community Develoment / Building
Would you be interested in also working as Volunteer Liaison Officer?	Yes No
What is your interest in the Uganda program?
Do you require any further information? Please state.
How did you locate our website?	Google.com Other search engine Volunteerabroad.com Idealist.org Findagap.com Environmentjob.co.uk Planetedu.com Worldwide.edu Globalenglish.com Other website Friend or Family
*** I have read, and agree to, your legal terms of service	I agree (You Must Check)
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