Volunteer

Volunteer Full Name
Sex
Date of Birth
Age
Address
Name of Institution
Telephone Number
Email Address
Passport Number
Language Proficiency
Name
Relationship
Residential Address
Primary Phone Number
Alternate Phone Number
Email Address
Do you have Insurance Cover?
Specify What Type of Insurance
Insurance Title or Name
Number
Insurance Contact Details
Date of Arrival
Aprox. Time of Arrival
Volunteer Start Date
Volunteer End Date
Departure Date
Aprox. Departure Time
Total Days to Volunteer
Photo (Passport Size)
ID
Date of Application
Full Name of Guardian
Full Name of Witness
 
Dominik Januvka Male 01/06/1988 31 Dumbierska 5, Kosice 04001, Slovak Republic Green Blue Life Uganda 00421904066383 dominik.januvka@gmail.com BJ6075161 EN Dorota Simonova Mother Dumbierska 5, Kosice 04001, Slovak Republic 00421902238606 00421902238606 dorotasimonova@gmail.com YES 05/07/2019 17:00:00 06/07/2019 14/07/2019 14/07/2019 13:00:00 8 d.jpeg 1 17/06/2019
Angie Female 26/12/1963 55 Ziwa Private +256772713410 genade@tutanota.com 1234567 English Nico Son xxxxx 1234567890 12345678 nico@hotmail.com YES Life Insurance Blah Blah 12345 angie@rhinofund.org 20/06/2019 00:45:00 21/06/2019 06/07/2019 07/07/2019 00:15:00 15 Mudukoyi Augustine.JPG 2 18/06/2019 XXXXXXXXXXX XXXXXXXXXXXXXXX
Martin Cupka Male 21/05/1983 36 Ve?ké Dvorany, 119, 95601 Green Blue Life Uganda +421904105246 martin.cupka@gmail.com BE0959584 English Fluent Kristina Volfova Friend Južná 478/9, Klin, 02941 +421918162098 00421918212181 volfovakristina@gmail.com YES Travel Insurance UNION 55458354 +420296339644 05/07/2019 17:00:00 06/07/2019 13/07/2019 14/07/2019 13:00:00 7 mcupka-face.jpg 3 18/06/2019
Milan Horacek Male 23/10/1976 42 Truby 2202, CESKA TREBOVA, CZECH REPUBLIC Green and Blue Uganda +420777277519 horacekmilan1@gmail.com 45181511 english starter Jitka Kutacova Sister dr Fikejze 733 Chocen, Czech Republic +420724770337 +420723178109 j.kutacova@seznam.cz YES Travel Insurance Alpenverein 104-172112/A/19 +43 (0) 1 2533798 05/07/2019 17:00:00 06/07/2019 14/07/2019 14/07/2019 13:00:00 8 IMG_20190620_102948.jpg 4 07/05/2019 Anton Ramza Zuzana Bila
Ludmila Kuklinkova Female 22/07/1968 50 Belohorska 147a, 636 00  Brno, Czech Republic Green and Blue Life Uganda 00420 724 770 337 ludmila.kuklinkova@gmail.com 42737934 english intermediate David Kuklinek Son Bednarikova 7, 614 00 Brno, Czech republic 00420 703 330 045 00420 778 884 500 kuklinek.david@gmail.com YES Travel Insurance Alpenverein 104-130781/A/19 00430 125 337 798 05/07/2019 13:00:00 06/07/2019 14/07/2019 14/07/2019 17:00:00 8 IMG_20190620_112116.jpg 5 07/05/2019 Anton Romza Zuzana Bila
ANGIE Female 12/04/2016 3 ANGIE ANGIE 1234 director@rhinofund.org 1234 English ANGIE Brother ANGIE 1234567890 123456 director@rhinofund.org YES Health Insurance ANGIE 12 ANGIE 31/07/2019 09:00 31/07/2019 29/08/2019 30/08/2019 17:00 29 IMG_0852.JPG 6 02/07/2019 NONE NONE
Tine Buyse Female 23/03/1989 30 Veldstraat 77 World of Wildlife +32474715043 tinebuyse@hotmail.com 592-4412599-53 Dutch / English Rudy Buyse Father Jan Breydelstraat 46, Harelbeke +32486486540 +32486121550 info@decoratie-buyse.be YES 16/11/2019 23:00 18/11/2019 27/11/2019 27/11/2019 23:45 9 PSX_20180608_131529.jpg 7 05/07/2019
0 0 8
Ssenfuma Paddy Kaye Male 12/07/1980 38 Kampala - Uganda Makerere University 256789023750 kaybroz@gmail.com B089056 English Mr. Kaye Charles Father Mukono 256704022272 256789023750 kaybroz@gmail.com YES 15/07/2019 08:00 15/07/2019 30/07/2019 30/07/2019 02:30 15 Ssenfuma Paddy Kaye.jpg 9 06/07/2019
Tine Buyse Female 23/03/1989 30 Veldstraat 77 , 8530 harelbeke, belgium World of Wildlife +32474715043 tinebuyse@hotmail.com 592-4412599-53 Dutch / English Rudy Buyse Father jan breydelstraat 46, 8530 HArelbeke Belgium +32486121550 +32486121550 info@decoratie-buyse.be YES 16/11/2019 22:45 18/11/2019 27/11/2019 27/11/2019 23:45 9 PSX_20180608_131529(1).jpg 10 08/07/2019
tine buyse Female 23/03/1989 30 Veldstraat 77 8530 harelbeke, belgium World of wildlife +32474715043 tinebuyse@hotmail.com 592-4412599-53 Dutch and English Rudy Buyse Father Jan Breydelstraat 46, 8530 Harelbeke, Belgium +3256712837 +32486121550 info@decoratie-buyse.be YES 16/11/2019 22:45 18/11/2019 27/11/2019 27/11/2019 23:45 9 PSX_20180608_131529(2).jpg 11 09/07/2019
ANGIE Female 26/12/1963 55 ANGIE ANGIE 0772713450 director@rhinofund.org 00000000 English ANGIE Auntie ANGIE 0676767676 000000000 director@rhinofund.org YES Travel Insurance eeeeeeee 90909099090 2221133455 31/07/2019 04:15 01/08/2019 16/08/2019 17/08/2019 04:15 15 IMG_0852(1).JPG 12 09/07/2019 soppopopop
Katerina Cermakova Female 06/10/1978 40 Rychnov na Morav?, 216, 569 34, Czech republic, Europe Green Blue Life Uganda Organisation +420 605 517 983 cermakova@vetys.cz 44342798 Czech, English, French Miroslav Pejchar Husband Rychnov na Morav? 216, 569 34, Czech republic, Europe +420 736 189 446 +420 434 119 pejchar@vetys.cz YES Travel Insurance ?eská pojiš?ovna 4189321783 +420 221 586 675 04/08/2019 18:00 05/08/2019 09/08/2019 10/08/2019 13:00 4 2019-07-12_optimized.jpg 16 12/07/2019 Anton Romza
Tomas Hora Male 07/08/1997 21 Sternberkova 14, Prague, 17000 Green Blue Life Uganda Organisation +420607720555 tomas.hora123@email.cz 42224462 Czech - native language, English - intermediate, Spanish - beginner Jan Hora Father Sternberkova 14, Prague, 17000 +420605135875 +420605135875 atelier.hora@volny.cz YES Travel Insurance UNIQUA travel insurance 1060510600 +420296333696 04/08/2019 18:00 05/08/2019 09/08/2019 10/08/2019 13:00 4 passport photo.jpg 17 12/07/2019 Anton Romza Jr. Jan Hora
Barend Christoffel Janse van Rensburg Male 14/05/2001 18 109 Denyssen Ave, Mountain View, Pretoria Private +41 794721746 jvrchristo@yahoo.com A03661428 English Ben Janse van Rensburg Father Villa B, 598 Chemin de Chane +41 794774043 +33 450427217 jvrben@yahoo.com YES Health Insurance Cigna 001/01137 +32 32931811 01/03/2020 13:00 02/03/2020 29/03/2020 05/04/2020 12:00 27 Christo Photo.jpg 18 14/07/2019
kenny Vangheluwe Male 17/04/1989 30 Andriespevernagestraat 117 8530 Harelbeke Belgie kenny Vangheluwe 0472244063 vangheluwe.kenny@hotmail.com 592-6547504-85 Dutch and englisch Annita louvaert Mother Nijverheidstraat 134A 8791 Beveren-leie 0476200450 0476200450 vangheluwe.kenny@hotmail.com YES Europe assistence 16/11/2019 23:30 18/11/2019 27/11/2019 27/11/2019 23:30 9 image.jpg 19 19/07/2019 / /
Tomas Hora Male 07/08/1997 21 Sternberkova 14, Prague, 17000 Green Blue Life Uganda Organisation +420607720555 tomas.hora123@email.cz 42224462 Czech - native language, English - intermediate, Spanish - beginner Jan Hora Father Sternberkova 14, Prague, 17000 +420605135875 +420605135875 atelier.hora@volny.cz YES Travel Insurance UNIQUA travel insurance 1060510600 +420296333696 04/08/2019 18:00 05/08/2019 09/08/2019 10/08/2019 13:00 4 passport photo(1).jpg 20 25/07/2019 Anton Romza Jr.
Katerina Cermakova Female 06/10/1978 40 Rychnov na Morave 216 Green Blue Life Uganda Organisation +420605517983 katerinacermakova@seznam.cz 44342798 Czech, English, French Miroslav Pejchar Husband Rychnov 216 +420736189446 +420731619257 pejchar@vetys.cz YES Travel Insurance ?eská pojiš?ovna 41893217-83 +420221586675 04/08/2019 18:00 05/08/2019 09/08/2019 10/08/2019 13:00 4 Cermakova.jpg 21 25/07/2019 Anton Romza Miroslav Pejchar
kenny Vangheluwe Male 17/04/1989 30 Andriespevernagestraat 117 8530 Harelbeke kenny Vangheluwe 0472244063 vangheluwe.kenny@hotmail.com 592-6547504-85 English and dutch Annita louvaert Mother Andriespevernagestraat 117 8530 Harelbeke 0476200450 0472244063 vangheluwe.kenny@hotmail.com YES 16/11/2019 22:00 17/11/2019 27/11/2019 27/11/2019 23:45 10 image(1).jpg 22 25/07/2019
Tomas Hora Male 07/08/1997 21 Sternberkova 14, Prague, 17000 Green Blue Life Uganda Organisation +420607720555 tomas.hora123@email.cz 42224462 Czech - native language, English - intermediate, Spanish - beginner Jan Hora Father Sternberkova 14, Prague, 17000 +420605135875 +420605135875 atelier.hora@volny.cz YES Travel Insurance UNIQUA travel insurance 1060510600 +420296333696 04/08/2019 18:00 05/08/2019 09/08/2019 10/08/2019 13:00 4 passport photo(2).jpg 23 29/07/2019 Anton Romza Jr. Jan Hora