Guidelines - Responsible Exchange and Volunteering 2018

Annex 2 – Application Form (Specimen) Organisation’s Name & Contact details

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APPLICATION FORM Please fill in all blue blocks

Project for which applying Personal Details Surname

First Names Date of Birth

Passport Number

Nationality

Physical address

E-mail address Contact number

Preferred project dates

Emergency contact person

References

First & Surname Contact number

Name and contact details 1 Name and contact details 2

E-mail address Special Considerations

Tick appropriate box or provide details

Dietary requirements

None

Vegan

Vegetarian Other (list)

Halal

Medical Are you on prescription medication Please list any medical conditions

No

Yes (list)

Eg – epilepsy, depression, insomnia, recent operations etc

Supporting documents Letter of motivation Police clearance certificate

Are they attached

Yes Yes Yes

No No No

Certificate of participation of previous exchange Anything else of relevance to your application?

SPECIAL NOTE: In the case of minors - Application must be signed by the legal guardian of the applicant with evidence that they are the legal guardian. - Project must be specifically designed (operational plan & staffing) to implement with minors. - Specific travel considerations, visa and required documentation appropriate to minors must be considered.

Assistance in this regard can be sourced from the Department of International Relations & Cooperation (South Africa) and the respective in-country embassies.

African German Youth Initiative Page 64 of 67

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