*** Name:
Your Name is Required.
Other Names:
Date of birth:
DD:
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM:
January
February
March
April
May
June
July
August
September
October
November
December
Year:
Gender:
Male
Female
Nationality:
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
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Canada
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Central African Rep
Chad
Chile
China
Cocos Islands
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Congo, Republic of
Cook Islands
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Cote d'Ivoire
Croatia
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Cyprus (North)
Czech Republic
Denmark
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East Timor
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Egypt
El Salvador
Equatorial Guinea
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Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
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Iran
Iraq
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Israel
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Jamaica
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Macau (China)
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Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
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Martinique
Mauritania
Mauritius
Mayotte
Mexico
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Moldova
Monaco
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Montserrat
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Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Northern Mariana Is
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
St Vincent Grenadines
Samoa
Sao Tome Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan (ROC)
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad Tobago
Tunisia
Turkey
Turkmenistan
Turks Caicos Is
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Is (British)
Virgin Is (US)
Wallis Futuna Is
Yemen
Yugoslavia
Zambia
Zimbabwe
Mailing address:
State (US Residents):
Post/Zip code:
*** Country:
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Rep
Chad
Chile
China
Cocos Islands
Colombia
Comoros
Congo, Dem Republic
Congo, Republic of
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Cyprus (North)
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong (China)
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau (China)
Macedonia (FYR)
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Northern Mariana Is
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
St Vincent Grenadines
Samoa
Sao Tome Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan (ROC)
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad Tobago
Tunisia
Turkey
Turkmenistan
Turks Caicos Is
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Is (British)
Virgin Is (US)
Wallis Futuna Is
Yemen
Yugoslavia
Zambia
Zimbabwe
Phone (home):
Phone (work):
Fax:
*** Email address (please check):
A value is required. Invalid format.
Alternate email address:
Highest qualification:
High School Graduate
Undergraduate
First Degree Graduate
Second Degree/Masters Graduate
Other
Other relevant qualifications and skills:
Work and travel experience:
Please state any health condition that you have, including allergies (it is important for us to be aware of any condition so we can be prepared in placing you):
*** Do you have a religious background? (Please specify)
How long would you like to volunteer for?
2 Weeks
4 Weeks
6 Weeks
2 Months
3 Months
4 Months
5 Months
6 Months
*** When will you arrive in Uganda ?
MM:
January
February
March
April
May
June
July
August
September
October
November
December
YY:
2009
2010
2011
2012
What volunteer program are you most interested in?
Health
Education
Training
Gender Empowerment
Sports
What is your second choice?
Health
Education
Training
Gender Empowerment
Sports
Would you be interested in also working as Volunteer Liaison Officer?
Yes
No
What is your interest in the Uganda program?
Do you require any further information? Please state.
How did you locate our website?
Google.com
Other search engine
Volunteerabroad.com
Idealist.org
Findagap.com
Environmentjob.co.uk
Planetedu.com
Worldwide.edu
Globalenglish.com
Other website
Friend or Family