Volunteer Application

Name (as it appears on your Passport): *

Contact Information

Phone: *

Cell Phone:

Current Address: *

Permanent Address: *

Email Address: *

Age: *

Marital Status: *

Partner:

If applying with a partner, please indicate their name here.

Volunteer Session Availability & Work Experience

If you are flexible in your choice of sessions please indicate your preferences 1–3.

1st Session Preference: *

May 28 – June 23 (4 wks) Application Due: Feb.10th - Acceptance Notifications: Feb. 15th

July 2 – July 21 (3 wks) Application Due: March 10th - Acceptance Notifications: March 15th

July 30 – August 28 (4 wks) Application Due: April 10th - Acceptance Notifications: April 15th

2nd Session Preference:

May 28 – June 23 (4 wks) Application Due: Feb.10th - Acceptance Notifications: Feb. 15th

July 2 – July 21 (3 wks) Application Due: March 10th - Acceptance Notifications: March 15th

July 30 – August 28 (4 wks) Application Due: April 10th - Acceptance Notifications: April 15th

3rd Session Preference:

May 28 – June 23 (4 wks) Application Due: Feb.10th - Acceptance Notifications: Feb. 15th

July 2 – July 21 (3 wks) Application Due: March 10th - Acceptance Notifications: March 15th

July 30 – August 28 (4 wks) Application Due: April 10th - Acceptance Notifications: April 15th

Please briefly describe your past employment and/or volunteer experience: *

Please tell us about your educational background: *

How did you learn about RSO?: *

Skills, Talents & Gifts: *

Describe why you are interested in volunteering with RSO and what particular skills, talents and gifts do you feel you can contribute to this program. (Please limit your response to one typed double-spaced page in length).

Health & Background Information

Have you ever had any major illness, accident, or operation?: *

If you answered "yes" to this question, please give brief details including dates, treatment, outcome, and follow-up.

Have you ever suffered from any psychiatric or psychological problem, including anxiety or depression?: *

If you answered "yes" to this question, please give brief details including dates, treatment, outcome, and follow-up.

Are you taking any medication, including inhaled asthma medication?: *

If you answered "yes" to this question, please give brief details including dates, treatment, outcome, and follow-up.

Have you ever been convicted of a crime?: *

If you answered "yes" to this question, please give brief details including dates, treatment, outcome, and follow-up.

Please list any allergies: *

List all pertinent insurance information: *

Emergency Contact Information: *

Travel Experience (especially in ASIA): *

References

We highly recommend that one of the references be an ecclesiastical leader.

Reference 1 Name: *

Reference 1 Address: *

Reference 1 Email: *

Reference 1 Phone: *

Reference 2 Name: *

Reference 2 Address: *

Reference 2 Email: *

Reference 2 Phone: *