South African Community Volunteer Project...

Costs	£1399 / $2798 (US) / €1818
Group Size	Up to 6
Countries Visited	South Africa
Dates	29 Mar to 26 Apr 2010 26 Apr to 24 May 2010 24 May to 21 Jun 2010 21 Jun to 19 Jul 2010 19 Jul to 16 Aug 2010

16 Aug to 13 Sep 2010
13 Sep to 11 Oct 2010
11 Oct to 08 Nov 2010
08 Nov to 06 Dec 2010
06 Dec 2010 to 03 Jan 2011
03 Jan to 31 Jan 2011
31 Jan to 28 Feb 2011
28 Feb to 28 Mar 2011
28 Mar to 25 Apr 2011
25 Apr to 23 May 2011
23 May to 20 Jun 2011
20 Jun to 18 Jul 2011
18 Jul to 15 Aug 2011
15 Aug to 12 Sep 2011
12 Sep to 10 Oct 2011
10 Oct to 07 Nov 2011
07 Nov to 05 Dec 2011

Fields marked * are compulsory

Trip Details

Trip*

South African Community Volunteer Project

Trip Date*

Your Personal Details

Title*

First Name*

Last Name*

Address*

Town / City*

County / State*

Country*

Postcode / Zip*

Email Address*

Confirm Email Address*

Email you use while travelling (if different from above)

Tel Home*

Tel Work

Occupation

Date Of Birth*

Day	Month	Year

Gender*

FemaleMale

Nationality*

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Emergency contact details

Name

Relationship to you

Tel Home

Tel Work

Address

Passport details

Number

Place and Date of Issue

Expiry Date

Day	Month	Year

Health and Physical Fitness

Do you suffer from any of the following? Asthma, Epilepsy, Diabetes, Allergies

Do you take any prescription drugs or medication? Have you had any psychological / psychiatric illness in the last three years? If yes to any of the above, please supply more info below.

Do you have any dietary requirements?

Do you smoke?*

Can you swim 200m unaided?*

Do you have a criminal record?*

If joining a marine trip

Are you a qualified diver?
If yes, please state your qualifications and number of dives recorded.

Qualified? No of Dives

Have you ever had a case (or suspected case) of DCS (Decompression Sickness)? If yes, please provide details

Other Details and Information

Please introduce yourself to the trip staff by telling us a bit about your interests, previous travel 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 trip. What do you hope to gain from it*

Please tell us if you have any queries / concerns about the trip which you are joining?

Where did you hear about Yomps*