Volunteer Application Form

You can download the Application Form in PDF format Here

VOLUNTEER APPLICATION FORM

1. Personal Information

Name: _________________________________________________ First Middle (Maiden) Last

Sex: Male/Female______ Birth date__________./__________. /________/ D M Y

Birthplace:_________________________________________ City State Country

Citizenship:_________________

Passport Number _________________ Place of Issue________________________

Date of Issue______________________ Expiration Date____________ Present Address:__________________________________________

Telephone number: Home_______________ Work_________________ Mobile: _________________ Evening: _______________ Fax: ____________________ Email (s) _________________________________________________

Permanent Address (if different from above)

2. Education Qualification / Training

High School__________________________________________________

College_______________________________________________________

Universities_____________________________________________________

Others____________________________________________________________

Special Skills_______________________________________________________

Specific programmes that interest you___________________________________

3. Volunteer Participation Objectives

Outline in detail your personal objectives in wanting to volunteer in Cameroon

4. Focus of Volunteering:

Education HIV/AIDS Education Agriculture Health and Social Well-being Participation and Governance Computer Training Secure Livelihood Gender Issues Adult Education Others (Please Specify) Nursing Orphans Youth Development Community Development

5. Duration / Availabilities:

Can start when_______________________End when________________________ Number of hours per day___________________________ Number of hours per week___________________________

6. Accommodation: Host Family Renting

7. Preferred Language of work: English /French

8. Milieu of work: Urban Rural

9. Special needs (please state any special requirement in respect of) Diet e.g. Vegetarian, religious or medical)

Executive Director, Cameroon Association for the Protection and Education of the Child (CAPEC) BP 20646 Yaoundé, Cameroon Tel+237 2030163 Mobile: (+237) 77 75 16 06 Fix(+237) 220 30163 Email:info@capecam.org capecam20@yahoo.com Website: www.capecam.org

11. Declaration

I certify that the information I have given is accurate and complete and I understand that CAPEC can use it for the purposed intended without notice and I also undertake to do the following if my application is granted; a. Pay part of my volunteer fees for my arrangements b. Acquire a visa for myself and arrange for my travel c. Acquire a medical insurance for myself before my departure to Cameroon

Signature___________________________ Date____________________________

Please provide two References: