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Volunteer Exchange Form

Personal Information

Name

Last Name

Sex Date of Birth

General Information

Address

Zip/city/Prov.

Paese

e-mail Telephone

Occupation Nationality

Emergency Contact

Name Telephone

Languages

Please use the "Remarks" field to specify a language not listed here

1: 2:

3: 4:

Remarks on Health/Special Needs/Diet

Past Volunteer Experience (indicate country, year and type of work)

Workcamp choices in order of preference

Why do you wish to take part in a volunteer project?

General remarks