Registration

This form is for an application from individuals who wish to participate in one of our volunteer programs. Once you have filled this in, please send to us at visionnepal3@gmail.com we will then reply to you as soon as possible to confirm your program. The next steps will be for you to send your flight details and a photo to us (so we recognize you at the airport).

  1. Basic Details
  2. Full Name: …………………………………………………………………
  3. Date of Birth: ……../……../……
  4. Sex: Male/Female.
  5. Nationality: ……………………
  6. Passport Number: …………………………….
  7. Current Contact Details
  8. Full Postal Address………………………………………………………….
  9. Email Address……………………………………………………….
  10. Contact Telephone Number…………………………………………….
  11. Emergency Contact Details
  12. Name of Contact…………………………………………….
  13. Relationship to volunteer………………………………………………
  14. Email Address……………………………………………………………
  15. Contact Telephone Number……………………………………….
  16. Your Program and motivation
  17. Please indicate which program(s) you wish to be involved in, or if you wish to create your own program, please outline the details here. ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
  18. Please outline your educational background and any relevant experience.

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  1. What is your primary motivation for participating in our volunteer program?

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  1. Please specify your desired time frames for program commencement and completion.
  2. Start Date……………………………………….
  3. End Date………………………………………….
  4. Special Requirements
  5. Do you have any medical considerations or needs that need to be considered? If yes, please specify.

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  1. If you have any scheduled excursions or additional interests you would like incorporated into your itinerary, please specify them here (with dates if known).

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  1. Other Questions
  2. If you have any additional questions please note them here.

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  1. How did you hear about Vision Nepal? (If online please specify the website).

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By signing here, I acknowledge that the above details are true and correct. I have thoroughly read the information provided on the Registration and pages of the Vision Nepal Website (www.thevisionnepal.com) and I am comfortable with the conditions implicit in these pages.

Full Name: ……………………………………………………..

Date: ………………………………..

Signature………………………….

Please submit this application form electronically. You may leave the signatory area blank. You will be asked to sign a copy of this form upon program registration in Nepal.

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