Registered NO: 22742/059/060             
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FORMAL APPLICATION FORM

 

Instruction: Make sure that you have filled out the application completely before submission.  Please submit application with $199 non-refundable deposit that will be deducted from your total program fees.  However, the fee will be completely refunded if we fail to provide you a placement/project. No application will be considered valid if not accompanied by the deposit fee.  Once we receive deposit & application, we will reply within 24-48 hours. Moreover, please give us 2-3 days to do all process of your application and match your placement, then we will immediately send you a notice of preliminary acceptance and a placement details.

 

1.0 PERSONAL DETAILS:

First name:   Last name:    Middle:

Date of birth:

Place of birth: Gender / Age:

Mailing address 1:

Passport no:

Date of issues:                Date of Expiry:

Nationality:

Home phone number ( incl. int’l code):

Mobile number ( incl. int’l code):

Other (specify):

E-mail address: 

2.0 IN CASE OF EMERGENCY NOTIFY TO:

Full Name:

Relationship:

Home phone number ( incl. int’l code):

Mobile: 

E-mail address:  

Other ( specify):

3.0 ACADEMIC BACKGROUND: ( Colleges & Universities only)

 

4.0 PROJECT  PREFERENCES ( listed in the website): ( Please list two choices in order of your perference)

No.

Priority of project

Program start date

Total length of stay in weeks

1.

2.

 

 

5.0 CHOOSE THE VOLUNTEER PROGRAMME YOU’RE INTERESTED

6.0 Country of Choice

   

Volunteer   Aboard
Internship   Aboard
Summer Voluter & Travel
Mini-Volunteer & Travel
Orphange Construction & Renovation     
Cultural Restoration  
Others ( Please specify)

Cambodia      
India     Nepal  Sri-Lanka  
Thailand                     
Vietnam    
Philippines  
Tibet    
Other ( please specify)    

   
 

7. Are you interested in taking the first week Language & Cultural program?    Yes      No
(This program is not available in Cambodia, Philippines)

8. Are you interested in taking the second week excursion and travel program?    Yes      No
(Please check, program maybe not available in all countries)
(This program is only available in Nepal & India)

9.0 Are you mentally and physically in good health for travelling and volunteer work?
(Please list if you have any allergies, medication etc)


10.0 Explain your motivations to participate in Asia Horizon volunteer program:




11.0 Do you have any experience in community work, which could be relevant for your present work? 
If yes, please list your work experience; when, how long, where, what kind of activities?



12.0 Please explain your work experience with developing countries. Have you ever experienced life beyond your comfort zone?



13.0 If you have any question or concerns, please write them here.



14.0 Do you like to receive the certificate of performance and certificate of award?
(If yes, you need to send us at least 1 -2 pages testimonial based on your volunteering work experiences)



15.0 Do you want to join our program promotion award program?
If yes, we offer up to $150 cash back for our potential volunteers for doing any types of publicity.  Please choose from the followings:

  1. Publication in any country’s news paper                                                                $150   
  2. Video & photos start to end of the program                                                           $125
  3.  1-2 pages testimonial with pictures                                                                      $50
  4. Volunteer Journal with photos                                                                               $75

16.0 Do you want to help us as a reference person for upcoming volunteer?  Yes    No

I hereby declare that everything in this form in true to my knowledge. I confirm that I have no other obligations, which might interfere with my participation in the Asia Horizon projects. I also agree on all terms and conditions given by Asia Horizon, including the organization’s responsibilities, my responsibilities, my liability waiver, and the termination of my volunteer program


Signature: Date: