Name
Email Address
HTML
Plain text
Name
Date of Birth
Gender
Male
Female
Nationality
Mailing Address
State (US Residents)
Post/Zip Code
Country
Phone (home)
Phone (work)
Fax
Email Address
Highest Qualification
Please select
High School Graduate
Undergraduate
First Degree Graduate
Second Degree/Masters Graduate
Other
Other Relevant Qualifications and Skills
Work and Travel Experience
Any Health Problems you may have
How long would you like to volunteer for?
Please select
4 Weeks
6 Weeks
8 Weeks
10 Weeks
12 Weeks
When would you like to go to Thailand?
Please select
January
February
March
April
May
June
July
August
September
October
November
December
Please select
2003
2004
Would you like to volunteer at the wildlife program or teach at the local school?
Please select
Wildlife program
Teaching
Both
Do you require any further information. Please state.
How did you locate our website?
I agree to your
legal terms of service
Yes
No
Would you like to receive our monthly Newsletter?
Yes (html)
Yes (plain text)
No
Legal Terms of Service - please
read me!
� copyright 2000-2003 www.volunteer.org.nz.
Site best viewed with Internet Explorer 5.5 or Netscape Navigator 6.2 or better
in at least 800x600 resolution.