logo Volunteer Bolivia Application

"Creating a Bridge to Understanding Bolivia and her People"


Please fill out this form and send by e-mail by pressing the "Send Application" button at the bottom of the form, or print it out and send by certified mail to: Bolivia Cultura, Casilla 2411, Cochabamba, Bolivia, South America.

PERSONAL INFORMATION
 
Name :     Last Name :  
 
Date of Birth :     day     month     year  
 
Gender :     Male     Female  
 
Marital Status :     Married     Single  

 

HOME ADDRESS :
 
Street :     City :  
 
State :     Country :  
 
Postal code :          
 
Nationality :     Passport # :  
 
Home Phone :     Office Phone :  
 
Fax :     E-mail :  
 
Contact (s) in case of emergency :
 
 
Program dates you will be in Bolivia with Volunteer Bolivia :
 

How did you hear about Volunteer Bolivia? Flyer? Friend? Internet? Other

 

MEDICAL INFORMATION
 

Do you have any medical problems including allergies or heart problems affected by high altitude that limit your abilities?      Yes/No.   Please explain :
 
 

HOUSING
 

Do you want to live with a family?      Yes/No.   If no, please specify your housing needs :
 
Do you have any dietary restrictions (vegetarian)?      Yes/No.   Please explain :
 
 

LANGUAGE
 

Level of Spanish :             Beginner  Intermediate  Advanced Fluent

Comments:

 

Other languages spoken :   

 

Other Spanish courses taken (please list):

 
How many weeks of Spanish classes? :     weeks
 

(Note: Volunteer Bolivia strongly suggests that volunteers take a minimum of one month of classes.)
 

VOLUNTEER POSITION
 

What type of volunteer work are you interested in? What skills or abilities do you bring to the volunteer position? What motivates you to want to come to Bolivia and volunteer? What are your previous volunteer experiences? Please include any other information you feel is pertinent to your application.
Note: The more detail you give us the better we can place you.
 
 

PAYMENT
 
  • All fees need to be paid in full upon arrival (no exceptions).
  • Payment can be made in cash, by personal cheque or credit card (3.5% surcharge).
  • All payments must be made in US Dollars or Bolivianos.
  • Bolivia Cultura reserves the right to determine refunds on a case by case basis. The deposit is non-refundable.
  • If a participant wishes to defer participation to a future date, the deposit may be applied

Bolivia Cultura requires a $us 200 deposit to reserve your spot in our program. This should be paid once you are accepted into the program and is non refundable. This can be in the form of a check made out to BOLIVIA CULTURA and sent by certified mail to: Casilla 2411, Cochabamba, Bolivia, South America

 
 

SPECIAL SERVICES
 

If you have special services that you wish to request of Volunteer Bolivia please detail them below or e-mail us at info@volunteerbolivia.org We can organize tours for both individuals and groups. Just let us know what you need.
 
 
Copyright © 2007 Volunteer Bolivia