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Volunteer Enrolment Form
Hello!

Thank you for your interest in 14,4km's Volunteer Programme in the Middle East and North Africa region.

Please fill out the form below so that we have an idea about you and your interests. (All your information will be held in the strictest confidence and will not be shared with third parties.)

Once we have processed your form we will be in contact via email.

All the best from the 14,4km team!
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Personal details
Name, Surname *
Email address *
Address (street, no., city, zip code, country) *
Date of birth *
MM
/
DD
/
YYYY
Nationality *
Phone (home landline/office/mobile no.) *
Contact in case of emergency (name and phone number)
Skype contact details
2. Skills and interests
a. Educational background *
What is your highest degree?
Other (please specify here):
Name of the institution of higher education:
The field of your studies (Studiengang) and number of semesters you have studied:
Subjects included in your course (Studienfächer):
If you have already gained another degree, please name it here:
b. Work experience
Current occupation (if not studies, or additional to studies)
Work experience (only if relevant):
Volunteering/internship experience (name of institution, dates, main tasks):
c. Language abilities
Native language
Other languages (specify level of proficiency according to EU scale A1 to C2)
d. Hobbies, Interests
e. Particular skills that you would like to name here (e.g. IT, art skills etc.)
f. How would you describe yourself?
3. Preferences in volunteering
a. Where would you like to volunteer?
If you want to volunteer with a partner organisation, which country do you prefer? (You can check more than one)
b. Is there a particular type of volunteer work you would prefer?
(Please check all that apply)
c. Is there a particular group you want to work with?
(Please check all that apply)
d. Are there any groups you would not feel comfortable working with?
Please explain below
e. Is the internship a compulsory part of your studies (Pflichtpraktikum)?
Clear selection
4. Time frame
a. How long would you like to volunteer for?
b. What is your time frame for volunteering?
5. Background verification
a. Have you ever been convicted of a criminal offence?
Clear selection
b. Have you ever been charged with neglect, abuse or assault?
Clear selection
c. Has your driver's license ever been suspended or revoked in any state?
Clear selection
d. Do you use illegal drugs?
Clear selection
e. Do you have any physical limitations or are you undergoing any treatment that might limit your ability to perform certain types of work?
Clear selection
f. Please list two non-family references whom we can contact for references (e.g. former teachers, supervisors, superiors)
g. How did you find out about us?
General Terms and Conditions
This document sets out the general terms and conditions for internships mediated by 14,4 km e.V, Boxhagener Strasse 57, 10245 Berlin (hereafter referred to as “the placing organisation”) between the volunteer and the receiving partner organisation.

I. Duties and responsibilities of the placing organisation
1. The placing organisation facilitates the internship for the volunteer with one of the receiving partner organisations.
2. The placing organisation is not responsible for any expenses incurred by the volunteer with regard to flights, travel, accommodation or living costs of the volunteer.
3. The placing organisation is not responsible for arranging accommodation for the volunteer at the location of the internship.
4. The placing organisation provides the volunteer with a written confirmation of the internship prior to the commencement of the internship if such a confirmation is needed for university or the job centre.
5. The placing organisation stays in contact with the volunteer during the internship and can be reached if an issue related to the internship arises. The placing organisation addresses such an issue through means of communication.
6. The placing organisation is not responsible for personal health or safety or the security of the volunteer during the internship at the receiving partner organisation or during the journey to and from the location of the internship.
7. The placing organisation cannot be held accountable for any complications that may arise during the internship due to unstable political circumstances or security concerns in the country or in the receiving partner organisation.
8. The placing organisation does not provide or pay for the legal representation of the volunteer if such need arises.

II. Duties and responsibilities of the volunteer
1. The volunteer understands that there are certain (security) risks associated with international travel and residence in a foreign country and that the placing organisation and the receiving organisation cannot control or eliminate these risks. These risks may include exposure to potentially serious health and safety hazards including, but not limited to: transportation accidents, storms, floods, earthquakes, and other natural disasters; infectious diseases, inadequate medical care, remote access to medical treatment; armed insurrections, riots and mass protests, and terrorist activities.
2. The volunteer is obliged to inform the placing organisation in a timely manner about anything that hinders the volunteer from doing the internship, from commencing the internship on the agreed date, or from completing the internship on the agreed date.
3. The terms, time commitment, and location of the internship are subject to mutual negotiation and agreement between the volunteer and the receiving partner organisation.
4. The volunteer is obliged to transfer a handling charge of 50 EUR to the following bank account of the placing organisation once the volunteer and the receiving partner organisation mutually agree on the terms of the internship.

Account holder: 14,4km e.V.
Bank name: GLS Gemeinschaftsbank
Bank sort code: 43060967 (BIC: GENO DE M 1 GLS)
Account number: 1221372400 (IBAN: DE56 4306 0967 1221 3724 00)

5. The volunteer is obliged to provide the placing organisation with a confirmation of the travel booking confirmation to the location of the internship at least 2 weeks before undertaking the journey.

6. The volunteer is obliged to provide an initial short report after the first two weeks of the internship which may be published on the Facebook page and the website of the placing organisation.
7. The volunteer is obliged to fill in the exiting evaluation form and to write a final report reflecting on the internship within two weeks after completing the internship which may be published on the Facebook page and the website of the placing organisation.
8. The volunteer is aware that the internship at the receiving organisation is unpaid unless agreed otherwise between the volunteer and the receiving organisation.
9. The issuance and form of an internship certificate is subject to mutual negotiation and agreement between the volunteer and the receiving partner organisation. An internship confirmation certificate can be issued only by the receiving partner organisation.


I hereby agree to the General Terms and Conditions of the 14,4km Volunteer Programme
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