Volunteer Questionnaire

Volunteer Name

First Name

Last Name

Email:

Kusewera is not a volun-tour-ism organization. We do provide an opportunity for people with a heart to truly serve, to join us in our efforts to empower and educate the wonderful children and adults in the communities we work in. We are people helping people help themselves.

What made you decide to go on this trip and what are your personal goals for this trip?

What do you see as your strengths that you can offer the KIDS we’ll work with and what skills do you posses that you feel will be useful on this humanitarian trip?

What do you see as your strengths that you can offer to the GROUP you'll be traveling with on this journey? ie, leadership, team player, nurturer, flexibility, friendliness, etc.

Have you been on any humanitarian trips overseas in the past?
YesNo

If yes, please explain

What are your personal goals for this trip? :

Multiple choice - Check all that apply:

To stay in good general health I typically:
Work out every day and eat well balanced mealsWork out 3-4 times a week and eat fairly wellHope to get in 1 workout a week, and try to watch what I eatI don’t really work out

When I hang out with my friends, I’m typically:
Doing something activeGoing to the moviesTrying new restaurantsAll the aboveI only have a few close friends, and we mostly stay inNone of the above, I cherish alone time

If I ever get overwhelmed or stressed, I usually:
Walk away, I need my own space to de-stressBuck up and handle it until I can have time to take a momentCry, not great with handling stressGet angry and tend to blow a fuseI don’t tend to get too stressed out, I quietly take a breather when I need to

When I’m not sure about a task, I will:
Let others take the reins and only assist when necessaryDo my best to figure it out and take the leadAdmit I’m not so sure, but happy to helpNone of the above, I don’t like doing things I’m not sure of

In group settings, I tend to:
Be the life of the partyModerately engage and enjoy the bondingQuietly enjoy the companyPut my headphones on and chill out to my favorite music

IMPORTANT questions to ask yourself:
1) Would I volunteer abroad if I had no cameras with me?

2) Does my current lifestyle, my social media persona and my attitude reflect the heart that I want it to reflect on the Kusewera Service Trip?

3) Am I ready to leave behind my world for 1-2 weeks, to fully embrace the culture, the needs, and the work that Kusewera is doing in these communities?

I understand it is my responsibility to check with my physician concerning immunizations:
YesNo

I understand the fundraising and cancellation policies set forth on the Kusewera website:
YesNo

I am committing to the Kusewera Humanitarian Service Trip and will adhere to the guidelines and policies set forth for both Kusewera and the locations we serve alongside.

Volunteer Signature

Date

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms and policies.

I verify that the information provided is true and to the best of my knowledge. I understand that misrepresentation of this information will constitute grounds to terminate participation on a Kusewera trip.