Overview
Application Form
Rotaract Club of Colombo
Application Deadline: 23rd November 2009
Application Form
Short answers except where indicated
Name*
Nationality*
Date of Birth*
Sex (M/F):*
Male
Female
Permanent Address*
City*
Country*
Sri Lanka
U.K.
U.S.A.
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Barbuda
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Botswana
Brazil
British Virgin isl.
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Rep.
Chad
Channel Islands
Chile
China
Colombia
Congo
Cook Islands
Costa Rica
Croatia
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Irak
Iran
Ireland
Ireland, Northern
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kuwait
Kyrgyzstan
Latvia
Lebanon
Liberia
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar/Burma
Namibia
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Rwanda
Saba
Saipan
Saudi Arabia
Scotland
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Togo
Trinidad-Tobago
Tunisia
Turkey
Turkmenistan
United Arab Emirates
U.S. Virgin Islands
U.S.A.
Uganda
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wales
Yemen
Zaire
Zambia
Zimbabwe
Telephone/Mobile*
Fax
E-mail*
Rotaract Club*
District
Number of years in Rotaract
Designation in club, if relevant
Spoken Languages and Proficiency (your fluency in each language)
Contact person and details in case of emergency (include Telephone number also)
What is your Previous Travel experience?
Do you have any dietary requirements or special needs? (Vegetarian, food allergies, religious customs, etc.)
Give a brief introduction about yourself. Include your interests, hobbies and involvement with Rotaract
Have you visited Sri Lanka before?
Why would you like to visit Sri Lanka? And if chosen what kind of things would you like to see?
How do you feel your Rotaract Club and you would benefit from such a visit?
What has been the best IU project you partook in and why?
Home stay and travel
The Rotaract Club of Colombo wants to give you a true Sri Lankan experience, and promote friendships between the hosts and our guests, therefore on some nights you will be staying in a Rotaractors home. How do you feel about home stay accommodation?
In order to find a suitable place for your home stay; are you a smoker and/or do you have and allergies (pets, food smoke, etc)?
Do you need a Visa to visit Sri Lanka? If yes, please let us know if you need a letter of recommendation?
Please enter image text into the below text box
PLEASE READ!
Escape to Paradise DOES NOT include airfare, visa, costs of heath or life insurance. We strongly advice you to contact your local Sri Lankan Embassy and enquire about such requirements on your visit to Sri Lanka.
Sponsored By
Rotary Club of Colombo
District 3220 Sri Lanka
Corporate Sponsors
Links
Rotary International
District Rotaract Organization
Charity Apple