Registration Form

I AM INTERESTED in participating in the iVolunteer International Workshop on

Volunteer Management in Disability. Please register me as a participant for the
workshop being held on the 12th and 13th of November 2008.

Name: Mr./Ms/Dr _________________________________________

Organisation and Designation: ________________________________________

Address: _____________________________________________________

Country: _____________________________________________________

Telephone: _________________________Fax: _______________________

Email: ________________________________________________________

Professional Responsibilities: ________________________________________

___________________________________________________________________

Your experience of working with volunteers: Extensive / Little / No Experience

I would like to use the skills acquired from this training for:
___________________________________________________________________
___________

___________________________________________________________________
___________

I am sending Rs. _________ by way of DD/Cheque No: ___________

Dated: _______________ Drawn on (bank): ___________________

*For International applicants, please contact prarthana@iVolunteer.in before

remittance.

FOR INTERNATIONAL APPLICANTS ONLY:

Date of Birth: _______________ Place of Birth:

______________

Nationality: _______________ Passport No:

______________

Place of Issue of Passport: _____________ Date of Passport Expiry:

______________

SIGNATURE AND DATE: ____________________________________