Medium Term Volunteer Application

Medium Term Volunteer Application Form

Names of projects you are applying for:

PERMANENT HOME ADDRESS: :

PRESENT ADDRESS: :

Contacts in Case of Emergency :

Date you are available for voluntary service:

How long do you want to serve:

Three references (no relatives)

If you need more space for the above questions, please attach a separate piece of paper and indicate which questions you are answering. Very often it is appreciated or required to attach a letter of motivation as well. Please attach your Current photo and the first 2 pages of your passport. Thank you.

I would like to participate in the medium term volunteer program organized and governed by PIVS Kenya Internship . I acknowledge what i am supposed to do and whether there may be extra activities in the program that I apply for. I agree not to sue PIVS Kenya Internship for any legal and financial damages and loss incurred during the program. I understand that I should pay for the insurance personally. Hereby, agree to take any responsibility for any injury and damage incurred in the program and to participate in any activity sincerely throughout the program. I accept the conditions of participation for the program by the host organization.