Volunteer Application Apply to volunteer with Agua Viva InternationalBefore you begin... 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"). Acceptable filetypes are .png, .jpg, .gif, or .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. Name * First Last Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepaNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweCountry Home Phone * Cell Phone Work Phone Email * Emergency Contact Name * First Last Emergency Contact Phone Number * Application QuestionsHave you ever traveled to a foreign country? *YesNo When and where? Maximum words allowed: 100. Total words: 0 Do you have a current passport? *YesNo 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.YesNo 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? *YesNo 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? *YesNo 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.YesNo What spiritual gifts and skills do you have and what team would you like to be a part of? *These are preliminary categories and may be revised as the project is further defined. (check one)Water System InstallationEducation Team, AdultsEducation Team, ChildrenLocal MissionsDental Provide any details regarding your team preference, if desired. Maximum words allowed: 250. Total words: 0 "Why I want to join Agua Viva on a trip..." *In 250 words, describe why you are interested in serving. Maximum words allowed: 250. Total words: 0 Application Fee Payment ($300) If you would like to pay your application fee with a credit card or PayPal account, check below. If you would like to mail a check, please make it out to Agua Viva International and mail it to: Agua Viva International, P.O. Box 8481, Kansas City, MO 64114.Yes, I would like to make the payment online today. Next 1 / 2 VerificationPlease enter any two digitsExample: 12This box is for spam protection - please leave it blank 2 / 2