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Volunteer Application Form

Special Care Unit

Name: 
Age: 
Gender: 


Home country:
State:
City:
   

Contact details

 
Email address: 
Phone: 
   
Occupation: 
Religious affiliation (if any): 
Sending organisation (if any): 
Proficiency in Mandarin: 
   

Emergency contact in your home country while you are in China

Name: 
Relationship to you: 
Phone: 
Email: 
   
Length of intended stay: 
Estimated date of arrival: 
Estimated date of departure: 
Please note: approximate dates are very important to us to be able to approve your application.
   
Medical qualifications
and experience: 
Medical problems/allergies: 
Anything else you would
like us to know about you: 
   

References (preferably with email addresses)

Please note: references are only required if applying to stay for more than 2 months. (Referees should be people who have been in a supervisory position over you, past or present such as employers, team leaders, church leaders etc. Family members or close friends are not considered suitable referees.)

Name: 
Relationship: 
Email: 
Phone: 
   
Name: 
Relationship: 
Email: 
Phone: 
   
                   

Please note: If coming as a team, only the team leader needs to complete this form. Please attach a list of names and ages and any important information (e.g. allergies) of other team members on a separate sheet.




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