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Volunteer Application Form
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*
Passport
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*
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Issued in
*
Country of issue *
Afghanistan
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Algeria
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Angola
Anguilla
Antarctica
Antigua and Barbuda
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Belize
Benin
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Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
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Burkina Faso
Burundi
Cabo Verde
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Cameroon
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Chad
Chile
China
Christmas Island
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Comoros
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Congo, Democratic Republic of the
Cook Islands
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Korea, Republic of
Kuwait
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Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
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Palestine, State of
Panama
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Paraguay
Peru
Philippines
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Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
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Saint Vincent and the Grenadines
Samoa
San Marino
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Singapore
Sint Maarten
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Slovenia
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South Georgia and the South Sandwich Islands
South Sudan
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Thailand
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Venezuela
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
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Zambia
Zimbabwe
Åland Islands
Country
Passport valid until
*
DD slash MM slash YYYY
Contact Information in case of Emergency
Emergency contact
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First
Last
Address Emergency contact
Street Address
City
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email
*
Phone Emergency Contact
*
Additional Information
Available to volunteer from
*
DD slash MM slash YYYY
Available to volunteer until
*
DD slash MM slash YYYY
Are these dates flexible?
*
Yes
No
Which location of ADI do you prefer?
*
Jerusalem (Please note: at the moment, ADI Jerusalem does not provide housing)
Negev
No preference
What is your proficiency in English?
*
None
Limited
Understand
Speak
Fluent
What is your proficiency in Hebrew?
*
None
Limited
Understand
Speak
Fluent
Do you speak other languages? Please list:
Hidden
What size T-shirt do you wear?
S
M
L
XL
XXL
Have you been to Israel before?
*
Yes
No
Professional Information
Are you a qualified care giver?
*
Yes
No
Current Profession
*
Professional Background
*
Do you possess any special skills which you can apply during your volunteering at ADI?
*
Yes
No
Which skills?
*
Motivation
What moves you to come specifically to Israel?
*
What moves you to specifically work with multiple disabled people? Why are you the right person for the job?
*
Promotion
We invest a of time and effort in order to create a good and fun volunteer program and try to make sure that every volunteer will have an unforgettable experience. Due to the vast investment of ALEH, we expect, as an essential part of your volunteering that also after your return home, you will be willing, for at least a certain period of time, to help out ALEH in a practical and active way.
Would you have any suggestions in what way you are able to help us out?
*
Additional Information you want to share with us
Memo of understanding
Hereby I declare:
To have completed this form truthfully.
To be in good health to be able to volunteer.
That I will take care of all travel expenses to Israel and to the point that I will be picked up by an employee of ALEH and back to my home country.
That I will take care of my own food (except for lunch during working days) if I am a volunteer at ALEH Jerusalem.
That I respect ALEH's policies and the decisions of the local managers.
That I will respect (religious) beliefs of others and will not impose my beliefs on others, or in any way disturb the religious and political beliefs and way of life of others.
That I have adequate health insurance and / or travel insurance with repatriation coverage for my entire stay in Israel and that I agree with any emergency treatments, anesthetics and operations as deemed necessary by attending physicians.
That I indemnify ALEH, its agents, employees, clients and other volunteers of any liability whatsoever arising from any injury, damage, or loss incurred by the undersigned during my involvement with ALEH.
That I ensure to maintain a good atmosphere and a pleasant living environment together with the other volunteers in the accommodations.
I am aware that I am sharing the apartment and possibly the room in the accommodation with other volunteers as notified by the volunteer coordinator.
I give ALEH permission to contact me by email and accept ALEH's
Privacy Policy
.
Agreement
*
I agree *