Prijavnica 2011

							Voluntariat - SCI SLOVENIA
Volunteers Exchange Form for workcamps in Europe, North America,
Australlia, Japan, South Korea and Mongolia



The form is going to be faxed on the workcamp organisation of your choise, so PLEASE fill in the form very CLEARLY, with computer or
by hand using BLACK pen in CAPITAL letters. Thank you.

1. a Surname/Family name        b) First name                       1 a) _______________________          b) ________________________
2. a) Date of birth    b) Age   c) Sex (M-male, F-female)           2 a) _______________________          b) ____________ c) _________
3. a) Nationality     b) Present occupation                         3 a) _______________________          b) ________________________
4. Permanent address                                                4 ______________________________________________________
                                                                     _______________________________________________________
5 a) Phone number b) Mobile number                                  5 a) _______________________          b) ________________________
c) Email address (PLEASE USE CAPITAL LETTERS)                       c) _____________________________________________________
6. Emergency contact : name, phone number of the contact person 6 ___________________________________________________
7. Passport number                                                  7    ____________________________________________________


8. Give details of your voluntary/comunity work experience including workcamps (SCI and outside)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________


9. a) Why do you want to do a workcamp with SCI? (for extra motivation, use a separate sheet of paper.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________


b) What do you think you can contribute to the workcamp as a volunteer?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________


10. a) Mother tongue_________________________________________ _________________________________________________


b) Other languages you speak. Put Language: G for good, F for fair, S for slight.
____________________________________________________________________________________________________________


11. a) Special wishes, e.g. vegeterian/muslim/jewish food etc, if you want to take a child with you,...
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________


b) Any serious accidents, illnesses, disabilities, allergies. SCI does not discriminate volunteers with a serious physical or mental
condition. Please give details of any conditions or regular medications you may have.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
12. Workcamps chosen in order of preference (e.g SI-SCI 9.1)
1.CODE ______________ NAME _____________________________________________ DATES _______________________________
2.CODE ______________ NAME _____________________________________________ DATES _______________________________
3.CODE ______________ NAME _____________________________________________ DATES _______________________________
4.CODE ______________ NAME _____________________________________________ DATES _______________________________

13. Motivation: Answer the following question for each of your choices.
a) repeat the name of each camp b) Why do you choose this particular workcamp? What do you expect from it?
1.a)_______________________b)_________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
2.a) ____________________ b) ___________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
3.a) ____________________ b) ___________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
4.a) ____________________ b) ___________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

Important! Volunteers are NOT insured against illnesses or accidents arising from special or mental disabilities (e.g. epilepsy, physical
handicaps, chronical illnesess) existing prior to the camp. Volunteers who fall into this category are advised to take out their own
insurance. By signin this exchange form I declare that I know the coverage of the SCI Insurance and that I realise that the SCI
Insurance is only an additional insurance. SCI expects the volunteer to participate in the whole programme which includes a written
evaluation of his/her workcamp.


With my signature I confirm that I have read general terms and conditions and that I accept them.


Place:   _____    _______ Date:      _______                    Volunteer signature:       ______________________