VOLUNTEER / PROGRAMME APPLICATION FORM

Before filling out this application, please read the Yearoutindia FAQ and the Volunteer Information Booklet.

PLEASE NOTE : Use TAB key to navigate between fields, once the form is fully completed click on
submit button to send the form. Do not use Enter Key while filling in the application form

* Preferred Program
* Preferred Start Date
* Preferred Duration
* Second Choice Program
* Second Preferred Start Date
* Second Preferred Duration
If you would like to take part in more than one program, please choose The Yearoutindia “Do It All” Program from the program list or tick this box
VOLUNTEER INFORMATION
* Title
* First Name
* Surname
  Preferred first name
* E-Mail Address
* Email you use while travelling
  (if different from above)
* Mailing Address
 
* City
  County
* Postcode
  Country / Region
* Phone (home)
* Phone (mobile)
  Occupation
* Date of Birth
e.g., 18/03/1980 (DD/MM/YYYY)
  Gender Male Female
  Nationality
  Do you have a Valid Passport Yes No
  Passport Number (Optional)
  Place and date of issue (Optional)
  Expiry date
Please Tick this box if you want to receive email newsletters from Yearoutindia. Please note we DO NOT pass your information to ANY third parties.
EMERGENCY CONTACT DETAILS
* Name
* Relationship to you
* Phone (home)
* Phone (mobile)
* Email
* Address

HEALTH AND PHYSICAL FITNESS   
   
Do you suffer from any of the following?  Asthma          Yes No
   Epilepsy         Yes No
   Diabetes         Yes No
   Allergies         Yes No
Do you take any prescription drugs or medication? Yes No
Have you had any psychological / psychiatric illness in the last three years? Yes No
If yes to any of the above, please supply more info.  
Do you have any special dietary requirements? Yes No
If Yes, please specify :  
Do You Smoke? Yes No
Can you swim 200m unaided? Yes No
VOLUNTEER INTERESTS
 
Please introduce yourself to the Yearoutindia Coordinator/Program staff by telling us a bit about your interests, previous travel / volunteering experience, language skills, first aid, and any other relevant information or qualifications which might be useful.
Please give your reasons for applying to join this internship / program / project. What do you hope to gain from it?
Please tell us if you have any queries about the program which you are joining?
Where did you hear about Yearoutindia?   
IMPORTANT
Please check if you have entered your email address correctly. Due to certain junk mail filters our emails to you may be categorized as junk mail and automatically moved to your trash box. To ensure this doesn't happen, please check for our response within 2 days of submitting your application and email us at info@yearoutindia.com if you haven't received a reply.
Thank you - Yearoutindia Team
          
          

On receipt of this completed form, we will mail a printed copy of the Application form
along with the chosen program details to the mailing address provided. A digital copy
will be mailed to the applicant where possible.


Contact the YOI support team at: info@yearoutindia.com
Call: +91 484 4020040 (India office) +91 9447231853, UK Tel: 0845 463 1571, 07092 233122 Fax: 07092 380001
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