VOLUNTEER EXCHANGE FORM

HOW TO PARTICIPATE TO A WORK-CAMP

1. Pay the fee of participation. You can choose between paying by credit-card or making a deposit on our bank-account.

Credit-card:
If you pay by credit card, please send us your credit-card details (name and birthdate of the cardholder, credit-card number, expiration date) by e-mail (volontariato@oikos.org) or fax (0039-06-5073233), together with the statement that you authorize Oikos to charge the fee of participation + 4% expenses.

Deposit on our bank-account (only within the EU):

You can make a deposit on our bank, and send us the receipt via fax (0039-06-5073233).
The whole bank expenses need to be covered by you.

Our bank-details:
Name of the Bank: Monte dei Paschi di SienaAg 15; via della Musica 2, 00128 Roma
Bank number (ABI): U-01030
Number of the branch office (CAP): 03215
Account number: 14042.46
Account holder: Associazione OIKOS
Code IBAN: IT 10 I 01030 03215 000001404246
BIC SWIFT: PASCITM1R15

2. Fill out the application form on this page (in English or Italian).

4. We will send you a confirmation by e-mail (be sure to provide us a correct e-mail adress)

In case we can't place you in the camps you've chosen, we will suggest you other work-camp opportunities. If you don't want to participate to one of these alternative camps, the fees payed (except the membership of 20,00 Euros) will be transformed in bonus to be used for the participation in a future camp). The participation fee is not refundable.

5. Volunteers coming from within the European Community, should bring with them the European Health Insurance Card (which substitutes the E111-form from 1 June 2004), in case you need health assistence.

6. Travel costs are not included in the participation fee, volunteers have to make their own travel arrangments.

7. For further questions send an e-mail to: volontariato@oikos.org

(We process application forms only after having received the participation fee)

Name/Surname Nome/Cognome:

E-mail:

Gender Sesso:

Permanent Address Residenza:

Present address Domicilio:

Phone Telefono:

Birthdate Data di nascita:

Birthplace Luogo di nascita:

Nationality Nazionalità:

Passport Number Numero del passaporto:

Occupation Occupazione:

Emergency Contact Da contattare in caso di emergenza:
Name/Surname Nome/Cognome:

Phone Telefono:

Languages Lingue parlate:

Remarks on Health/Special needs Problemi particolari di salute:

Past volunteer experiences Esperienze di volontariato:

General skills Competenze:

Name Workcamp 1 choice Denominazione del primo campo:

Code Workcamp 1 Codice

Date Workcamp 1 Data

Name Workcamp 2 choice Denominazione del secondo campo:

Code Workcamp 2 Codice:

Date Workcamp 2 Data:

Name Workcamp 3 choice Denominazione del terzo campo:

Code Workcamp 3 Codice :

Date Workcamp 3 Data :

Notes:

Date :

The Personal data submitted with this application will
be handled in compliance with the Italian Data Protection Act
(D. L. vo 196/2003) and for the sole purpose of participating
to a volunteering program.