YOUR PERSONAL DETAILS:
Full Name* (as it appears on your passport:
Title:
Please select...
Mr Mrs
Ms
Miss
Professor
Doctor
Male or Female?
Please select...
Male Female
Telephone No. (if
you don't have a telephone, please put "no phone"):
Mobile/Cell:
E-mail*:
Your Address:
Nationality:
Date of Birth
Place of Birth (can be submitted
later)
Passport No. (can be submitted later)
Do you hold a student card?
Yes
No
WHICH PROGRAMME
or COMBINATION OF PROGRAMMES WOULD YOU LIKE?
If you would like to do two or more programmes, please enter
information here for your FIRST programme:
1. Which COUNTRY?*
Please select...
Argentina
Australia
Brazil
Brunei
China
Ghana
Guatemala
India
Kenya
Malaysia
New Zealand
Peru
South Africa
Sri Lanka
Tanzania
Thailand
Zambia
Zimbabwe
Latin American Triangle
2. Which type of PROGRAMME?*
Please select...
Teaching English
Teaching Another Subject
Teaching Drama
Coaching Sports
TOTAL Sports
Summer Camp
Community Development
Care or Social Work or Creche
Care for Kids
Conservation
Work Experience Placement
Australia - Wildlife Rehabilitation Centre
Argentina - Mix & Match
Argentina - Tourism/Adventure
Course: Language
Course: Wildlife Conservation
Course: Photography
Course: Salsa
Course: Tango
Course: Capoeira
Course: Theatre
Cultural Exchange
Sri Lanka - A Rural Experience in Wasgamuwa
Sri Lanka: Combined Elephants & Teaching
Sri Lanka: Combined Zoo and Teaching
Any additional
information/comment?
3. If CONSERVATION, select which Project:
Please select...
Australia - Wildlife Rehabilitation Multiple Project
Australia - Wildlife Sanctuary
China - Giant Panda Conservation Project
Peru - Amazon Conservation Project
Malaysia - Diving Project
Malaysia - Orang Utan Project
Malaysia - Lok Kawi Wildlife Project
South Africa - Wildlife Conservation COURSE
South Africa - Wildlife SANCTUARY
South Africa - Wildlife Rehabilitation
South Africa - BIG FIVE Game Parks
South Africa - White Shark Project
South Africa - Multi-Marine Project
South Africa - Dolphin RESEARCH
Sri Lanka - Elephant Orphanage
Sri Lanka - Colombo Zoo
Zimbabwe - Lion Breeding Project
Zimbabwe - Hwange Game Reserve
4. If WORK EXPERIENCE, select which Sector:
Please select...
Hotel &
Catering/Hospitality
Adventure Tourism
Journalism
Law
Medical
Physiotherapy
Tourism
Veterinary
Other
5.. If you are taking a Language
Course , which level would you like?
Please select...
Elementary
Intermediate
Advanced
6. Is your choice one of the listed Combined Projects ?
Yes
No .
If yes, which one:
1st
Placement DURATION
7. From (approx. date)
8. To (approx. date)
9. For how many months (or
weeks)?
10. Would you like additional time to travel? If yes, how many weeks:
SECOND PROGRAMME:
If you would like to do two or more programmes, please enter
information here for your SECOND programme: (Please note,
this is NOT for your second choice, it is for a SECOND
PLACEMENT):
If you're only doing ONE placement, please
skip to here
11. Please select your
SECOND placement country
Please select...
Australia
Argentina
Brazil
Brunei
China
Ghana
Guatemala
India India
- South
Kenya
Malaysia
New Zealand
Peru
South Africa
Sri Lanka
Tanzania
Thailand
Zambia
Zimbabwe
Latin American Triangle
12. Select 2ND type of PROGRAMME?
Please select...
Teaching English
Teaching Another Subject
Teaching Drama
Coaching Sports
TOTAL Sports
Summer Camp
Community Development
Care or Social Work or Creche
Care for Kids
Conservation
Work Experience Placement
Australia - Wildlife Rehabilitation Centre
Argentina - Tourism/Adventure
Argentina - Mix and Match
Course: Language
Course: Wildlife Conservation
Course: Photography
Course: Tango
Course: Salsa
Course: Capoeira
Course: Theatre
Cultural Exchange
Sri Lanka - A Rural Experience in Wasgamuwa
Sri Lanka: Combined Elephants & Teaching
Sri Lanka: Combined Zoo and Teaching
13. Any additional information
or comment?
14. If CONSERVATION, select which Project:
Please select...
Australia - Wildlife Rehabilitation Multiple Project
Australia - Wildlife Sanctuary
China - Giant Panda Conservation Project
Peru - Amazon Conservation Project
Malaysia - Diving Project
Malaysia - Orang Utan Project
Malaysia - Lok Kawi Wildlife Project
South Africa - Wildlife Conservation COURSE
South Africa - Wildlife SANCTUARY
South Africa - Wildlife Rehabilitation
South Africa - BIG FIVE Game Parks
South Africa - White Shark Project
South Africa - Multi-Marine Project
South Africa - Dolphin RESEARCH
Sri Lanka - Elephant Orphanage
Sri Lanka - Colombo Zoo
Zimbabwe - Lion Breeding Project
Zimbabwe - Hwange Game Reserve
15. If WORK EXPERIENCE, select which Sector:
Please select...
Adventure Tourism (Outward Bound)
Hotel &
Catering/Hospitality
Journalism
Law
Medical
Physiotherapy
Tourism
Veterinary
Other
16. If you are taking a Language
Course , which level would you like?
Please select...
Elementary
Intermediate
Advanced
17. Is your choice one of the listed Combined Projects ?
Yes
No
If yes, which one:
Second
Placement DURATION
18. From (approx. date)
19. To (approx. date)
20. For how many months:
21. Would you like additional time to travel? If yes, how many weeks:
FLIGHTS
22. Would you like us to arrange
your flights?
Yes
No
If you have any comments or
questions, please enter them here:
YOUR EDUCATION DETAILS:
1. Are you currently a
student?
Yes
No
2. On the date of your departure, will you be:
Please
choose one:
A university graduate
An undergraduate
In your Gap Year
3. If a graduate
or undergraduate, which University?
4. What Subject?
5. If you are in your Gap Year, what school do/did you attend?
6. Do you have
a proposed university, and if so, which university?
7. Would you teach a second subject
if needed (e.g. geography, maths, music, sport)?
Yes
No
8. If yes, which
subject/s?
9. Do you have any other skills which you could teach?
10. Please give a brief description of your experience (or you can send us
a CV later if that is easier). If you'd like to send a CV now, please
click here
GENERAL INFORMATION DETAILS:
1. Would you like to travel with a friend who is also doing a Travellers
placement?
Yes
No
2. If yes, which friend/s?
3. Do you have any handicaps or disabilities? (This is to help us ensure
that you get the best out of your placement)
4. What do you most hope to gain from your placement?
5. Please list your
hobbies/interests:
6. Where did you FIRST hear about Travellers? (Please be as specific
as you can)
7. Where did you FIRST hear about our
WEBSITE?
8.
If you would like
to pay by CREDIT CARD , please tick here:
9.
If you would like
to pay by CHEQUE , please tick here:
10.
Do you accept our Terms & Conditions?