Name
*
First Name
Last Name
Gender
*
Email Address
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Language(s) Spoken
*
Preferred Volunteer Region
*
Raleigh/Durham, North Carolina
St, Vincent of the Grenadines
Volunteer Roles
*
Please select one or more options
Availability
*
Please select one or more options
Technical Skills
Please list any technical skills that you have
Why would you like to volunteer with us?
*
Would you be willing to complete a personal background check?
*
Yes
No
Passport number
*
Are you currently enrolled in High School or College?
*
What year will you Graduate?
*
General Health
*
Please list an dietary concerns
*
Do you have a history of drug or alcohol abuse?
*
If yes, please explain. If no, please put N/A in the space.
*
Have you been hospitalized fo an emotional or mental illness within the last year?
*
If yes, please explain. If no, please put N/A in the space.
*
Are you under a physician’s care or receiving prescribed medication?
*
If yes, please explain. If no, please put N/A in the space.
*
Please provide a reference —chosen adult that can speak to your character (Name & Telephone)
*
Please provide an emergency contact — this person will need to be given emergency contact information before you leave for trip. (Name/ Relationship/email/telephone)
*
Can you swim?
*
Do you play any sports? If yes, please indicate which sports.
*
Have you ever traveled outside of the US?
*
Describe your experience working with young people. (Your peers or youth younger than yourself.)
*
he mission of Taiwo Foundation is to empower youth to effect meaningful change in their communities. What do you believe is the biggest issue affecting today’s youth?
*
What do you hope to gain from participating in the Taiwo Foundation Cultural Immersion and Service Learning Program?
*
If you could teach youth in another country or culture, what would be the topic and kept message(s) you would convey?
*
I attest that all information submitted is true.
*
Applicant electronic signature and date.
*
