Volunteer Application

Apply to volunteer with Agua Viva International

Before you begin filling out this application, note that you will need to download, fill out, notarize, and scan a copy of the Agua Viva Medical Release Form and scan a copy of your current passport (if you have it) to upload both items into this application.

FOR THE MEDICAL RELEASE FORM: Download the medical release form here. Please fill out and notarize the form, and name the file beginning with your first and last name (for example, John Smith’s file would be named “John Smith Medical Release Form.pdf”).

FOR YOUR PASSPORT: Please name the file beginning with your first and last name (for example, John Smith’s file would be named “John Smith Passport.pdf”). Acceptable filetypes are .png, .jpg, .gif, or .pdf.

Personal Information

Name *

Address *

Apt, suite, etc.

Country

City

State

Zip code

Home Phone *

Cell Phone

Work Phone

Email *

Emergency Contact Name *

Emergency Contact Phone *

Application Questions

Have you ever traveled to a foreign country? *

Yes

When and where?

Do you have a current passport? *

Yes

What is the expiration date? *

Passport

Please name the file beginning with your first and last name (for example, John Smith’s file would be named “John Smith Passport.pdf”). Acceptable filetypes are .png, .jpg, .gif, or .pdf.

Have you had the required vaccinations? (Hep A, Hep B, Typhoid, Tetanus) *

We would like for you to carry a letter from your doctor indicating what you have been vaccinated for and stating that your vaccinations are current.

Yes

Prior to departure, you must provide to Agua Viva a list of medications you are taking and/or medical conditions that you may have. Are you willing to do this? *

Yes

Medical Release Form

Download the medical release form here. Please fill out and notarize the form, and name the file beginning with your first and last name (for example, John Smith’s file would be named “John Smith Medical Release Form.pdf”). Acceptable filetypes are .png, .jpg, .gif, or .pdf.

Can we assist you with your fundraising? *

Yes

Our accommodations are typically gender segregated, but shared. Are there extenuating circumstances that require you to have private accommodations? *

This would be an additional cost.

Yes

What gifts and skills do you have and what team would you like to be a part of? *

Check one. These are preliminary categories and may be revised as the project is further defined.

Water System Installation

Education Team — Adults

Education Team — Children

Local Missions

Dental

Provide any details regarding your team preference, if desired.

“Why I want to join Agua Viva on a trip...” *

In 250 words, describe why you are interested in serving.

Application Fee Payment ($300)

If you would like to pay your application fee with a credit card or PayPal account, check below.

Yes, I would like to make the payment online today.

Verification *

For security verification, please enter any random two digit number. For example: 29

Apply to volunteer with Agua Viva International

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