Volunteer Enrollment Form
First name
Last name
Birthdate (mm-dd-yyyy)
Age
Gender
Nationality (by passport)
Country of residence
Street address
City
Province / State
Postal Code / ZIP Code
Phone(s) (incl. country and area code)
E-mail
Current occupation
Employer / Educational institution / Other
Languages spoken
Health problems  No   Yes, specify
Emergency contact name
Relation to you
Phone and/or fax and/or e-mail
Volunteer experience  No Yes, specify

Project choice according to your preference
Country / Project title / Project dates
1
2
3
4
5
6
please, note that more project choices will increase your chances to be placed
I want to be placed together with my friend
Remarks
Your motivation to volunteer in the chosen project(s)
Payment information
Financial contribution
Please, choose your method of payment and fill out either part A. or part B.
A.   I will mail a cheque payable to:
CADIP - Canadian Alliance for Development
Initiatives and Projects
353-1350 Burrard St.
Vancouver, BC,
V6Z 0C2, Canada
B.   Credit card:  
Name of cardholder
Billing address
Credit Card Number
Expiration date (mm/yy)
I acknowledge and accept CADIP Terms and conditions for participation in a volunteer project
(please, note that without this confirmation your request can not be proceeded)