Engaged Citizens Programme Application 2022
Coordinator : Dr. RC Oosthuizen
Sign in to Google to save your progress. Learn more
Name: *
Surname: *
Student number: *
Identity Number *
Email address *
Are you a returning volunteer or first time? *
Do you already know which partner site you want to volunteer at? *
If yes, please indicate which partner site
Male/female:
Clear selection
ID/Passport number: *
Nationality:
If on exchange please indicate the name of your home university/college:
Exchange students only: length of your stay?
Clear selection
Languages (indicate level of proficiency: basic/fluent) *
Cellphone number: *
Faculty and Department *
Degree & year of study: *
Societies & sports:
Other interests and skills that you have that you feel you can use while volunteering? Please list these.
Why do you wish to become a volunteer? *
Have you done volunteer work before? If so, please supply a brief description of the work you did, where you did it (at Rhodes or outside of Rhodes) and your experience. *
What type of volunteer work do you wish to do?  (if you know the name of a specific project or organisation, please specify) *
Required
For returning volunteers: If you were involved in ECP previously, please specify which projects you were active in
For returning volunteers: would you consider remaining in the same project or prefer a new project? Please explain your answer
Considering your timetable and any other commitments at Rhodes, how much time are you able dedicate to volunteering activities, please specify days?
Do you need transport in the RUCE bus to the community site every week?
Clear selection
As a potential Student Volunteer you will be required to attend the training for volunteers provided by the Community Engagement Office. Training is mandatory for returning and new volunteers as we must explain the new Student Volunteer Team structure to all. Please offer suggestions of issues/topics you wish to learn more about at the training *
RUCE often hosts events throughout the year, please specify what your meal preference is for our general catering purposes *
I, being a major, hereby on behalf of myself, my executors, my assigns and all my dependants who are at present entirely or partly dependant on me, or who may in the future be dependent on me, fully indemnify, hold harmless and absolve Rhodes University and the organisation where I volunteer, and their respective officers, employees and management, from any responsibility whatsoever in the event of an injury to my person or possessions while participating on a voluntary basis in the Rhodes University Community Engagement Engaged Citizens Programme. I further accept that no compensation whatsoever will be paid by the State, Rhodes University and/ or the organisation where I volunteer, to me or my executors, my assigns, my heirs and dependents in the event of an injury to my person or damage to my property while participating in the Rhodes University Community Engagement  Engaged Citizens Programme. *
I, undertake to abide by the rules as laid down by the “Engaged Citizen Programme” namely: I realise I cannot claim for any illness or injury I may sustain while performing my duties as a volunteer. I commit to maintaining a strictly professional relationship with whomever I interact with in the course of my volunteering. I may not interfere with the people I meet in the course of my volunteering concerning their religion or politics or interfere with their privacy in any way. I will respect the language, culture and status as a human being of all the individuals I will encounter in the course of volunteering. I undertake not to interfere with the policy or the administration of the organisation at which I volunteer. I undertake that I will contact the designated Organisation staff member if I am unable to visit my placement as agreed. I understand the commitment that I am making and that I cannot get a substitute to replace me should I for any reason be unable to report to volunteer. I understand that Rhodes University and the organisation I volunteer with will not be responsible for any act or omission which may lead to a civil claim by a voluntary worker as a result of carrying out duties as a voluntary worker. I, having been granted permission to take part in the Student Volunteer Programme for the purpose of volunteering undertake that: I will regard all information pertaining to the organisation at which I volunteer as confidential; and I will not supply information regarding the organisation or its patients/clients to members of the public or the media without written permission of the Head of the Organisation. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rhodes University. Report Abuse