APPLICATION FORM FOR HEALING THROUGH TOURISM

VOLUNTEER PROGRAM

Program Applied For:

Live with the Lenca Indians, Learn Ecotourism Skills, and Teach English

APPLICANT INFORMATION

Applicant Name: _______________________________________________

Date: __________________

School Name (if currently attending): _____________________________________________________

Company Affiliation (all applicants, please): ________________________________________________

Street Address: _____________________________________________________

City/State/Zip: _____________________________________________________

Business Phone: ________________ Home Phone: ___________________ Fax: __________________

E-mail address: __________________________________________________________________________

Please note if you DO NOT want to be called at work: _____________ Best time to call? _________

SURVEY INFORMATION:

Are you directly involved in community development? (If no, then go to question 6.)

[ ] Yes [ ] No

Describe your role(s).

What departments do you work with?

How long have you been involved in volunteering?

Are you involved in community development as your full time job?

[ ] Yes [ ] No

Why do you want to intern with the Healing Through Toursim Volunteer Program

Do you own a personal computer? [ ] Yes [ ] No

If yes, what kind? [ ] Mac [ ] IBM compatible

Do you have access to the Internet? [ ] Yes [ ] No

What type of work/tasks would you like to perform as part of your Healing Through Tourism Volunteer Program?

[ ] Volunteer training

[ ] Intern

[ ] Tourism Development Volunteer

[ ] Community Sanitation

[ ] Facilities Builder

[ ] English Teaching

[ ] Teaching Community Leaders

[ ] Other _______________________

You may pay through PayPal for your Healing Through Tourism Volunteer Adventure

I AM READY TO SHARE MYSELF!

Please enroll me in the Healing Through Tourism Program For:

Program Length	Program Fee in US Dollars (US $)	Pay Through PayPal

1 Week	585
2 Weeks	1199
3 Weeks	1334
4 Weeks	1469
5 Weeks	1604
6 Weeks	1739
7 Weeks	1874
Eight Weeks	2009
Nine Weeks	2144
Ten Weeks	2279
Eleven Weeks	2414
Twelve Weeks	2549
Thirteen Weeks	2689
Fourteen Weeks	2829
Fifteen Weeks	2979
Sixteen Weeks	3119
Seventeen Weeks	3259
Eighteen Weeks	3409
Nineteen Weeks	3549
Twenty Weeks	3689

Service	Fee In Us Dollars	Pay Through PayPal
Airport Pickup and Return in San Pedro Sula or Tegucigalpa	US$90
Registration/Membership fee	US$150

Your Registration/Membership Fee entitles you to membership in our community. You will never have to pay another Registration Fee for any of our programs.

I enclose the entire cost of $US ______________

Here are the three dates I would like to come to Honduras to be a Volunteer

1st choice __________ 2nd choice ___________ 3rd choice ___________

[ ] Other: ______________________________________________

______________________________________________

Please also submit by email:

	Program Application
	Copy of your passport (information page only)
	Resume/CV
	Two References: preferably professional and/or character references
	Four 1½" x 2" official passport-size photos, signed on the back
	One smiling full-length photo of yourself

----------------------------------------------------------------------------------------------------------------------------------

For office use only:

Oragnizational Affiliation : _______________

Assigned to: _______________________________________________

Please complete and email to honducopa@yahoo.com

Back to Live with the Lenca Indians, Learn Ecotourism Skills, and Teach English