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HOME
ABOUT US
OUR MISSION
THE FOUNDERS
MEET THE TEAM
GALLERY
VIDEOS
APPLY HERE
PROGRAM DETAILS
GET INVOLVED
FAQS
CONTACT
COUNTRIES
INDIA
INDONESIA
USA
UTAH
BLOG
DONATE NOW
NEEM 2022 Summer Humanitarian Trip Application
What trip(s) are you applying for?
*
Indonesia, July 3- 16, 2022
If you're not accepted for the trip you're applying for, are you wanting to be considered for the other trip?
*
No
Yes
N/A
Name
*
Choose One
*
Female
Male
Other
Phone Number
*
Address
*
Include City & State
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
Email
*
Age
*
Occupation (If you're a student, state major & year in school)
*
Have you traveled with NEEM before?
*
Yes
No
How did you hear about NEEM?
*
Google Search
Campus
Instagram
Youtube/Vimeo
Friend
Do you have a spouse or friend(s) who are also applying that you plan to go with? (If yes, state who & if you would/would not go without them)
*
Please list allergies or dietary restrictions you have. Enter "None" if you have none. (ie. vegetarian/vegan, allergies to food or pets, etc.)
*
Do you have any medical accommodations that we need to be aware of?
*
In the space below, please tell us about yourself and your background.
*
Please explain why you are interested in volunteering with NEEM, and what you feel you can contribute to the program (i.e. why we should pick you)
*
Relevant qualifications, skills, and/or areas of interest that you believe will benefit this program (ie. medical/nursing qualifications, CPR certifications, social worker, bilingual, photography/videography, etc.).
*
If you had to be shipwrecked on a deserted island but had your basic needs taken care of, what two items would you bring?
*
Please Upload A Picture of Yourself
*
Optional--Link portfolio, website, resume, etc.
Verification
Please enter any two digits
*
Example: 12
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