E-mail: 

First Name: 
Last Name: 

Gender: Female    Male

Marital Status: Single    Married   Other

Birthdate: Day/Month/Year 
Birthplace: 
Nationality: 

Home Address: 
City: 
Postal or Zip Code:
Country:

Home Phone: 

Mobile Phone: 

Occupation:

Universities Attended (Degrees if any):

Major Courses Studied):

Work experienc appropriate to this application

Other work experience

Have you been outside your country? Where?

Languages: 

Special abilities, hobbies:

Specify the volunteer position you are interested in
(Sellect more than one by holding down ´Control¨ key):




For what period are you planning to participate in our programme?:

In which location or locations would you like to volunteer?

(Sellect more than one by holding down ´Control¨ key):



How are you planning to arrive in Peru (by air or overland)?


When are you planning to arrive in Peru?
Please give as exact a date as possible now.
(Note: If this answer is too vague your application may not be processed)

How long are you planning to stay in Peru?
How much time will you spend working with us?
(Note: If this answer is too vague your application may not be processed)

Is this your first time in Peru? if not please explain.

 

Do you have a special diet or medical condition (details please)?



How will you finance your volunteer trip and posting: scholarship, grant, with your own money?

Please tell us if you are planning to travel with another person
and what he/she is going to do while you are with Serendipity?
in case of an emergency, whom must we inform in your home country?
Name, Phone, E-mail:

Please specify your level of Spanish: Basic Functional   Advanced

What are your personal goals, what would you like to take away from this experience?

Why have you chosen to work with us?

Please tell us how you found out about us:


Have you read and do you agree with the General Information
Terms, Projects and Opportunities set out in this web site?

 Yes    No

Additional comments or questions:


Date: