We do not charge any subscription fee. Therefore we ask you to only sign up if you are really sure that you want and can take part in an international volunteer program in Brazil. Your subscription already incurs in some costs to analyze and develop our communication.
Please download and print the Iko Poran International Volunteer Agreement. Your application will only be considered after we receive by fax (55.21) 3852.2917 or mail the signed agreement.

After we receive your application form and the signed volunteer agreement, someone from our team will contact you to guide you through the next procedures to format your unique, productive and rewarding volunteer experience. 

 
PERSONAL INFORMATION

Program start date:

Day

Month

Year

Program end date:

Day

Month

Year

First Name:

Middle Name:

Last Name:

Name (as written in your passport):

How you prefer to be called:

E-mail:

Mailing address:

City

State

Country

Zip Code

Permanent address (if different from above):

Home Telephone:

Country code

area code

phone #

Work Telephone:

Country code

area code

phone #

Birth date

Day

Month

Year

Gender
Male Female
Nationality
Present Occupation
 

PROGRAM INFORMATION
 
Do you have a valid passport?
Yes No

Valid until

Day

Month

Year

Passport #:
I.D:
Have you ever been to Brazil?
Yes No
If yes, please indicate the nature of your trip:
 
Please list countries of previous international travel and the type of travel (tourist/ volunteer/ educational, etc.):
Country:  Nature:
 
Please list the languages you speak:
How did you learn about volunteer work in Brazil?
Do you have any dietary restrictions we should know about? If yes, please explain:
 
CURRENT AND PAST EXPERIENCE
 
Prior volunteer experience:
 
Professional history: please attach a resume
Education:
Name of Institution Year of Graduation
High School:
College: 
Post-Graduation/ 
MBA
 
Please describe any other formal, or informal, educational experiences that may be relevant
 
Please list contact information for three (3) personal references:
1) Name

Telephone:

Country code

area code

phone #

E-mail:
2) Name

Telephone:

Country code

area code

phone #

E-mail:
3) Name

Telephone:

Country code

area code

phone #

E-mail:
 
 
Abilities and Interests 
 
For us to assure that the Participants in our programs feel totally rewarded by their energy, creativity, resources and work, please fill out the form below. Our staff will use this form to develop your Work Plan, together with you and the partner institution.

 Please enumerate your abilities:
HEALTH
Hygiene Education

Traditional Nutrition

Health Education

Modern Nutrition

Sanitary

Other: Which
 
THERAPEUTIC WORK
Drugs Rehabilitation 
Physical Therapy / Physiotherapy 
Alcohol Rehabilitation
Sexual Abuse Rehabilitation
Recreation Therapy
Prevention DST
Games Therapy
Occupational Therapy
Rhythmic Dance /
Aerobics Exercises
 
MEDICINE
If you are in a medical profesional and have a specific specialization, please indicate in which area:
 
EDUCATION
Informal
Esportive
Which sports:
Languages(s):
Which:
Others:
Which:
Do you have more ability to work with Children or Adults? 
 
TECHNICAL KNOWLEDGE
Business Plan (Small Industry)
Income Generation Activities (Sewing, Painting, Mechanics, other.)
Computing 
Fundraising
Publicity
Marketing
Beauty Salon
Photography 
Other Abilities
Which:
 
ARTS AND CRAFTWORK
Dance
Theater
Music
Poetry
Circus
Graphic Arts
Painting and Drawing
Marché Paper
Sculpture
Paper craft
Other
Which:
 
OFFICE WORK
Many of our projects require help in their offices. 
Please enumerate your disposition to work at an office:
would rather not would accept would rather work
List other abilities not mentioned above:
 
INTERESTS
Please indicate which of the abilities listed above you are most interested in sharing. 
These do not have to be the areas in which you are better qualified.
1-
2-
3-
Are you willing to work in any area you may be needed, regardless of your skills and interests?
Yes No 
Answering, “Yes”, then we will feel free to place you in an area where is needed, although it may not be an area that you have specified as your desire.
Please list any other factors you would like us to consider, or make any other comments. 
What is your primary motivation for participating in our program? 
Please describe which qualities you have that will allow you to adjust to a new environment:
 
 
Health and Emergency
 
Blood Type:
Do you have any MEDICAL CONDITION(s) - such as allergies, heart disease, emphysema, diabetes, seizures, depression, injuries, recent surgery, etc. - important to know of in a matter of emergency?

No Yes, if "Yes", please specify condition(s):
Do you have any medical condition(s) that may be affected by conditions such as high humidity, altitude or air pollution?
No Yes, if "Yes", please specify condition(s):
Do you have a history of mental or emotional instability? 
No Yes, if "Yes", please specify condition(s):
Are you currently under the care of a physician for any of the above-mentioned conditions?
No Yes, if "Yes", please explain:
Do your medical condition(s) and/or restriction(s) noted require special arrangements, equipment, or assistance for you to participate in an active schedule as described in the program description in which you wish to participate?
No Yes, if "Yes", please describe: 
Do you require any prescription medications on a regular basis?
No Yes, if "Yes", please list the name(s) of and reason(s) for taking said medication(s) or simply write "NONE":

Personal Physician’s name
Telephone

Country code

area code

phone #

24-hour emergency number if available
 
CONTACTS IN CASE OF EMERGENCY
Name:

Relationship:

Address: 

City:

State:

Country:

ZIP: 

Day Phone:

Country code

area code

phone #

Night Phone:

Country code

area code

phone #

 
I certify that the all the information above is correct and true.