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Volunteer Application Form
Name
Estimated dates you wish to volunteer
Email
Telephone
Mobile
Address
City
State/Province
Zip/Postal Code
Country
Date of Birth
Passport #
Profession or course of study
How did you learn about HondurasChildren?
On a scale of 1-5 (5 being the best), how well do you write Spanish?
1
2
3
4
5
On a scale of 1-5 (5 being the best), how well do you read Spanish?
1
2
3
4
5
On a scale of 1-5 (5 being the best), how well do you speak Spanish?
1
2
3
4
5
Please check any of the following areas in which you have had experience:
Teaching
ESL
Arts and Crafts
Social Work
Computers
Special Needs
Psychology
Sports/Fitness Training
Music/Singing/Drama
Nutrition
Swimming/Lifeguard
Carpentry/Construction
Management
Other (please elaborate)
Have you ever worked with children or adolescents?
Yes
No
If yes, in what capacity
Describe your present or previous occupation:
Have you ever worked or volunteered in a developing country before?
Yes
No
When and Where
What are your hopes for your volunteer experience
Do you have any health concerns or medical restrictions?
Yes
No
(Please Explain)
Do you have any allergies
Yes
No
(Explain)
Do you have any dietary restrictions?
Yes
No
(Explain)
Optional: In case of an emergency, we would like to have your health insurance information on file. Please provide your health insurance information:
In case of emergency contact...
Emerg. 1 Name
Emerg. 1 Address
Emerg. 1 City and Country
Emerg. 1 Phone #
Emerg. 1 Email
Emerg. 1 Relationship
Emerg. 2 Name
Emerg. 2 Address
Emerg. 2 City and Country
Emerg. 2 Phone #
Emerg. 2 Email
Emerg. 2 Relationship
Please provide the name and address of 3 references other than family who have known you for at least 3 years. We especially need email addresses and phone numbers.
Ref. 1 Name
Ref. 1 Phone
Ref. 1 Email
Ref. 1 City & Country
Ref. 1 Relationship
Best time and best way to contact Ref. 1?
Ref. 2 Name
Ref. 2 Phone #
Ref. 2 Email
Ref. 2 City & Country
Ref. 2 Relationship
Best time and way to contact Ref. 2?
Ref. 3 Name
Ref. 3 Phone#
Ref. 3 Email
Ref. 3 City & Country
Ref. 3 Relationship
Best time and way to contact Ref. 3?
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