AVC Application Status

(x)Pending ( )Processing ( )Reviewed ( )Withdrawn

First Name *

Last Name *

Email Address *

Birth Date *

(clear)

Gender *

Female Male (clear)

Country of Citizenship

Passport Number (for Country of Citizenship noted above) *

Country of Birth

Current Street Address *

Current Street Address 2

Current City *

Current State / Province *

Current Zip / Postal Code *

Current Country *

Provide a long term/permanent address.

Permanent Street Address *

Permanent Street Address 2

Permanent City *

Permanent State / Province *

Permanent Zip / Postal Code *

Permanent Country *

Home Phone Number *

Mobile Phone Number

Website

Marital Status *

Single Married

Dependents *

Yes No

If yes, please name spouse and dependents and list dates of birth

Have you ever been convicted of a felony or a misdemeanor? *

Yes No

Are any charges for any offenses, including traffic offenses, civil suits, or judgements outstanding against you? *

Yes No

If you answered yes to either question above, please explain

Select your degree of proficiency with the following languages.

Armenian - Reading & Writing *

None Fair Good Excellent

Armenian - Speaking & Understanding *

None Fair Good Excellent

English - Reading & Writing *

None Fair Good Excellent

English - Speaking & Understanding *

None Fair Good Excellent

Russian - Reading & Writing *

None Fair Good Excellent

Russian - Speaking & Understanding *

None Fair Good Excellent

Other Language (Please Specify)

Educational Background

Please fill out as completely as possible.

Are you currently a student? *

Yes No

Have you graduated High School? *

Yes No

Undergraduate College/University Name

Year of Graduation (yyyy)

Major of Study

Minor of Study

If you attended graduate school, please fill in the following section.

Graduate School Name

Year of Graduation (yyyy)

Degree Awarded

Area of Study

Other Specialized Education or Training

Emergency Contact Information

It is essential that AVC be able to contact someone in the unlikely case of an emergency during your volunteer service. The information provided below must be for two individuals who do not live in the same residence and who may be contacted during the time you intend to be volunteering in Armenia.

Emergency Contact 1

First Name *

Last Name *

Street Address *

City *

State / Province *

Country *

Phone Number *

Secondary Phone Number

Email Address

Emergency Contact 2

First Name *

Last Name *

Street Address *

City *

State / Province *

Country *

Phone Number *

Secondary Phone Number

Email Address

Health Information

Please fill out as completely as possible.

Do you have any known medical conditions? *

Yes No

If yes, provide details

Are you currently taking any type of medications? *

Yes No

If yes, provide details

Do you have any known allergies (medical, food, or other)? *

Yes No

If yes, provide details

Have you ever had a major operation, illness, or accident? *

Yes No

If yes, provide details

Have you seen a physician for anything other than a regular check up in the last five years? *

Yes No

If yes, provide details

It is advised that you check with your physician regarding any recommended immunizations. However, it is recommended to receive the following vaccinations prior to serving in Armenia. Some of these vaccinations are childhood immunizations required for school attendance. However, you may need booster shots to maintain your immune status.

Please note the immunization dates below in yyyy format (i.e. 2008).

Hepatitis A or Immune Globulin (yyyy) *

Hepatitis B (yyyy) *

Tetanus or Diphtheria (yyyy) *

Measles (yyyy) *

Polio (yyyy) *

Required Documents

Carefully read the instructions for each item.

Please write a statement (500-800 words) explaining your reasons for wanting to volunteer in Armenia, how these reasons are related to your past experience (living/studying in a foreign country or in the Armenian community in your home town), and how they might fit in with your future goals. Comment on what you expect to contribute to Armenia through your service and what you expect to receive. Please provide an example of a significant experience - drawing from school, work, home or abroad - that illustrates your ability to adapt cross-culturally and to overcome difficulties. Write this in a separate document and then copy and paste it into this box.

Personal Statement *

Upload a current resume by clicking on the button below.

Resume *

References

Please download this form, send it to two appropriate individuals (supervisor, professor, colleague, etc) not related to you and ask them to email it directly to info@avc.am with your name in the subject line.

If you prefer the document in a .doc format click here.

Note - Filling out the following Cross Cultural Experience statement is only necessary if you intend to serve in Armenia for more than 4 months.

Although diasporan and homeland Armenians share the same ethnicity, their ideas, values and cultures may differ from one another. Non-Armenian volunteers will also encounter these differences. Volunteers, therefore, must work hard to understand this new culture, and be able to cope with being misunderstood, disappointed, and unable to communicate effectively in the beginning. Living in Armenia is also difficult due to the overwhelming needs of the country and the lack of comforts we take for granted. Please write a short statement (300-750 words) about a significant experience - drawing from school, work, home or abroad - that illustrates your ability to adapt cross-culturally and to persevere in the face of such adversity. Write this in a separate document and then copy and paste it into this box.

Cross Cultural Experience

Additional Information

This section gives us information about your interests and desired term of service.

Please check a maximum of four areas of volunteer service in which you are most interested.

Volunteering Interests *

If other, please explain

If accepted, when would you like your volunteer assignment to start? *

(clear)

If accepted, when would you like your volunteer assignment to end? *

(clear)

Desired location of assignment *

Yerevan Out of Yerevan Combined Wherever I am most needed

How did you learn about AVC? *

If other, please explain

Review Birthright Armenia's requirement here.

Are you eligible to apply to Birthright Armenia? *

Yes No

By checking this box and submitting this application you agree that the information you have provided is accurate.

Press Save only once. Your application will take up to a few minutes to be submitted.

Do you agree? *

Yes

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