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City Volunteer Application Form
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1. Personal Details
Name:
Permanent Address:
Temporary Address:
Email:
Contact No. : Mobile No.:
Gender:
Parents: Father’s Name:
Mother’s Name:
Local Guardian’s Name: Relation:
Contact No.: Mobile No:
Academic Qualification
| S. No. | Institution | Faculty | Degree/level |
| 1 | | | |
| 2 | | | |
| 3 | | | |
2. Your Involvement
a. What are you doing these days beside study? Please mention type of involvement and engaged time
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b. Your past involvement as volunteer/ employee/ any other types of services (please mention the date and name of organization of involvement)
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c. Extra Curricular Activities/ Training/ Any Particular Skills
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3. Your Field of Interest: Use (√) mark in appropriate box
Climate Change ( ) Water and Sanitation ( )
Air Pollution ( ) Others ( )
4. How would you like to contribute as city Volunteers besides school-based program? Use
(√) mark in appropriate box
5. Research and Survey ( )
6. Youth/College based program ( )
7. Mass Education and Awareness ( )
8. Training and Workshops ( )
9. Publication (Newspaper, Article, etc) ( )
10. Community Based Program ( )
11. Media and Communication ( )
12. Other ( )
13. What are your expectations from City volunteers Program? (Up to 100 words)
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14. Why do you want to involve in City Volunteer program (Statement of Motivation)? (Up to 200 words)
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15. Identify a major environmental problem in your community/college/school, and as a city volunteer how do you want to tackle this problem? (250 to 300 words)
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16. Your availability for the program
| Day | Time (in hrs) |
| Sunday | |
| Monday | |
| Tuesday | |
| Wednesday | |
| Thursday | |
| Friday | |
| Saturday | |
I want to contribute as city volunteer program for ………………………. year/ months
…………………………
Signature
Date:
Please fill in the form and email to gyc.nepal@gmail.com or submit directly to Global Youth Circle on August 28, 2010 along with your CV (not more than 3 page)
Global Youth Circle
Koteshwor-35, Kathmandu Nepal
Tel No: 977-1-2050715
E-mail: gyc.nepal@gmail.com
Website: www.gycnepal.blogspot.com
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