Action Volunteer Alliance
Volunteer Abroad. Change a life. Get work experience. Your adventure starts here.
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Application Form
*Name (Last, First)
*Date Of Birth - Month
-Select a choice-
January
February
March
April
May
June
July
August
September
October
November
December
*Date Of Birth - Year
*Date Of Birth - Day
-Select a choice-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*Gender - Female/Male
-Select a choice-
Female
Male
*Address Field 1
Address Field 2
*City/Town/Village
*Province/State
*Country
*Postal/ZIP Code
*Primary Phone Number
Secondary Phone Number
*E-mail Address
Secondary E-mail Address
*Highest level of education
-Select a choice-
High school diploma
College diploma
University diploma
Other
Please explain any relevant work experience
Please notify us of any travelling you have done.
Please tell us about any volunteer work you have done.
Please indicate any health problems you have, including allergies or disabilities. It is important for us to know about any condition which may affect you so we can be prepared in your plaement.
When would you like to start volunteering?
-Select a choice-
January 1st
January 15th
February 1st
February 15th
March 1st
March 15th
April 1st
April 15th
May 1st
May 15th
June 1st
June 15th
July 1st
July 15th
August 1st
August 15th
September 1st
September 15th
October 1st
October 15th
November 1st
November 15th
December 1st
December 15th
Year?
-Select a choice-
2009
2010
2011
How long would you like to volunteer for?
-Select a choice-
2 weeks
1 month
6 weeks
2 months
10 weeks
3 months
14 weeks
4 months
18 weeks
5 months
If other, please specify.
What projects would you like to take part in?
Orphanage
Teaching English
Building
Health Post
Conservation
Culture Exchange
*What training package would you like?
-Select a choice-
No training
Culture training only
5 days of training
7 days of training
Please tell us why you would like to volunteer in Nepal.
Questions or comments?
How did you hear abour Action Volunteer Alliance?