Indonesia International Workcamp
Individually we change ourselves, globally change the world!
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Sunday, 05 September 2010
Aplication Form
  
Application for:
Location:
First Name:
Family Name:
Gender:
Date of Birth:
Age:
Present Address:
Present Phone:
Permanent Address:
Present Occupation:
Nationality:
Passport Number:
Major in school/Univ.:
E-mail Address:
Passport Photo:
Emergency contact
Name:
Address:
Phone:
Mother Tonguee:
Language Skills:
Previous voluntary service or work camp experience (when/where/what/which organization):
General Skill:
Motivation or expectation for joining this project:
Anything else you like to mention (ideas to this project, message to others, etc):
What you can contribute for the voluntary activities and your sending organization after your return:
Remark on health/special need (illness,diet,disabilities,allergies,vegetarian,oetc). Do you have insurance?
*Please send this form as soon as possible but not later than the period chosen
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