APPLICATION FORM

All fields are required

                Section I :PERSONAL DATA

Surname* :

      First Name* :

Sex* :

                                            Age*            :

Country* :

                                            Zip Code*    :

Permanent address* :

Home phone* :

     Work phone* :

Email* :

Section II: CURRENT EMPLOYER  ( fill in if applicable otherwise reply with "NO")
Company name:* :
Postion held:*

   Responsibilities*
City:*
Time:* :
Address:* :

                Section III : VOLUNTEER EXPERIENCE Include all experiences performed as volunteer(fill in, otherwise reply with "NO")

Voluteer experiences as volunteer if any fill in, otherwise reply with* :

                Section IV :VOLUNTEER EXPERIENCE with AGV

Your country of interest (Madagascar or Kenya)* :

Your area of interest as volounteer with AGV (eg working with Women, children, youth programs, teaching, fundraising, mobilization)* :

What skill and experience can you bring to volunteering for AGV??* :

What do you hope to gain from volunteering with AGV* :

Availability and time commitment from (date)* :

 

To (Date)* :

  Hours per day* :

                Section V : PROFESSIONAL / CIVIC REFERENCES

Name* :

Oragnization* :

Address* :

Country* :

Email address* :

Relationship to you* :

                Section VI : PERSONAL REFERENCES (IN CASE OF MERGENCY)

Name* :

Address* :

Country* :

City* :

Phone* :

Email address* :

Relationship to you* :

              ACKNOWLEDGMENT

        To the best of my knowledge, the information contained in this application is complete and accurate. 
        I understand that providing false information is grounds for not choosing me for a volunteer position 
        or for my discharge if I have already been chosen.
        Nothing contained in this application or pre-volunteering communication is intended to or creates a
        contract between myself and AGV
        I understand and agree that, as part of volunteering with AGV, my details will be held in a confidential
        database that is only used for reasons relating to my volunteering.
        I HAVE READ AND UNDERSTAND THE ABOVE PROVISION

 

Accept* :