HELP CHILDREN AND COMMUNITIES
Founder: Mr. Jean William, JEAN CHARLES
E.mail: chalolo4@yahoo.com
Legally Recognize by:
Social Affairs: STC - 14087
DOMINICAN REPUBLIC MISSION TRIP/ JANUARY 2013
Application Form
Home phone: _______________Cellphone:_____________BirthDate:__________
Address: ___________________________________________________________
City: _____________State:__________Zip:________E.mail:_________________
Company/School: _____________________________Grade level: ____________
Emergency Contact
Name: ____________________________________Relationship:______________
Home Phone: ______________________________CellPhone:________________
What would you like to learn from your volunteer experience? __________________________________________________________________
List your special hobbies, skills and talents: ______________________________
What languages do you speak fluently? __________________________________
Volunteer work experience____________________________________________
How did you hear about us? ___________________________________________
Have you ever been convicted of a crime? __________if yes, please explain: ______________________________________________________________________________________________________________________________________________________________________________________________________
I certify that all information submitted by me on this application is true and complete. I understand that if any false information, omissions, misrepresentations, are discovered, my application maybe rejected and active volunteer status maybe terminated at any time. In consideration of my volunteer application, I agree to adhere to the policies and regulations of SOSAEC HAITI.
Signature: _______________________________________________________
DOMINICAN REPUBLIC MISSION TRIP/ JANUARY 2013
Travel Date: January 24, 2013 (From Haiti to Dominican Republic)
· We should meet together in January 23, 2013 in Haiti before the Trip
· Fee for the Trip: $400 USD, This amount will cover your Transportation, Feeding and Housing while you are there in DR. (That money can be providing once you arrive in Haiti or send it via Bank Transfer).
Ps: If you also desire to help us meet the needs for this program there, it is allowed but it’s not mandatory!
E.mail : sosaec.haiti@yahoo.com
BLOG: sosaec-haitijeancharles.blogspot.com
Website: www.sosaechaiti-volunteers-network.webs.com
No comments:
Post a Comment