* Required answer  **Required if applicable
First Name: *  
Last Name: *  
Middle Initial:  
Address 1 (Home): *
Address 2 (Home):  
City: *
State/Province: **
Postal Code: **
Country: *
Office Phone: *
Cell Phone:  
Home Phone:  
Email Address: *
Alt Email Address:  
Gender: * |
ITT Group / Value Center: *
Address 1 (Office): *
Address 2 (Office):  
City: *
State/Province: **
Postal Code: **
Country: *
Are you a member of a local Water For People Committee? *
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If yes, which one?
Background Information
  Conversant Fluent  
English:  
Spanish:  
French:  
Bengali:  
Other (please specify):  

Water For People works in some of the poorest and most isolated parts of the developing world. We often work in areas that are hard to access, and thus our work can be extremely strenuous. Access to US-style healthcare facilities is rare. As such, are there any physical or medical limitations that may impact on your ability to participate as a volunteer in-country that we should know about (indicate yes or no and explain yes in box below)? *
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Regions/Countries where World Water Corps opportunities are available:
(Please indicate those you would be interested in pursuing.)
In-Country Volunteer Opportunities:  
Guatemala: Nicaragua:
Bolivia: Ecuador:
Honduras: Dominican Republic:
India: Rwanda:
Malawi: Uganda:
    U.S.-based Support:
Type of Volunteer Opportunity in Existing Countries?  
Mapping:
Monitoring:
Evaluation:
Mentoring:
Time you could allocate to work in-country?
Less than 7 days    7 to 14 days    More than 14 days
General Experience
Event Planning:
Publications:
Photography:
Database Management:
Graphic Design:
Advertising:
Communication/Advocacy:
Programmatic Experience
Financial Planning/Management:
Micro-Finance:
Tariff Setting/Management:
Cost Evaluations:
Social Marketing:
Strategic Planning:
Gender-Focused Programming:
Program Monitoring:
Data Analysis:
Needs Assessments:
Program Evaluations:
Program Management:
Utility Management:
GIS:
Health and Hygiene Education in Developing Countries:
International Water Supply Development Experience Rural Peri-Urban
Asia:
Africa:
South/Central America:
International Sanitation Development Experience  
Asia:
Africa:
South/Central America:
Water Technology Experience Design/Construct Operations & Maintenance
Spring/Gravity Fed System:
Surface Water:
Hand-dug Wells:
Drilled Wells/Boreholes:
Hand Pumps:
Electric Pumps:
Diesel/Gas Pumps:
Disinfection Systems:
Filtration:
Other Treatment:
Quality Control/Supervision:
Distribution Systems:
Sanitation Technology Experience  
Pit Latrines:
Pour-Flush Latrines:
Waterborne Sanitation:
Sewage Collection:
Sewage Treatment:
Additional Comments:
Water For People will take all reasonable measures to provide a safe environment to work in. That said, countries are unpredictable and accidents are possible. Would you be willing to sign a waiver indemnifying and holding harmless Water For People of all liability related to your time volunteering for Water For People? *
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Water For People has initiated the volunteer program to help strengthen its overseas work with the involvement of water and sanitation professionals in North America. As this is a volunteer program, Water For People cannot provide financial assistance to volunteers. Volunteers are expected to cover their personal costs. Water For People can provide ideas on how to raise funds for your trip if needed. Water For People does recognize the names and companies of those who do volunteer. As a volunteer, do you agree to independently finance your trip, including all associated costs? *
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