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Guide to Local Partner Institutions for Completing the PNVSCA Request for Volunteer Form (For Foreign Volunteers)

1. Type all entries and answer all items by providing the requested information or checking the appropriateboxes. Write N/A for items that are not applicable. Only complete and properly filled requests will beprocessed.

2. The current partner Foreign Volunteer Sending Organizations (FVSO) are: Australian Volunteers forInternational Development (AVID); Australian Youth Ambassadors for Development (AYAD); ForumCivil Peace Services (Forum ZFD), German Agency for Technical Cooperation (GIZ), Japan OverseasCooperation Volunteers (JOCV); Korea Overseas Volunteers (KOV) ; Organization for Industrial,Spiritual & Cultural Advancement (OISCA); United Nations Volunteers (UNV); United States PeaceCorps (USPC); and Voluntary Service Overseas (VSO).

3. Submit one Volunteer Request Form per project. If the project requires two or more volunteers, submitone work and financial plan per volunteer.

4. For non-profit/non-government organization requesting volunteers for the first time, attach a copy of theCertificate of Registration with the Securities and Exchange Commission (SEC) and Certificate ofRegistration or Accreditation with concerned government agency.

5. Ensure that the names, designation and signatures of the officials submitting the VRF are complete andaccurate. The VRF must be submitted by the following as signatories:

National Government Agency Head of Agency, i.e. Department Secretary, or authorized representative not lower than a Director

Local Government Unit Provincial Governor, Municipal or City Mayor

Academic Institution President or equivalent highest official

Non-Government Organization Highest executive officer, i.e. Chief Executive Officer, President, Executive Director

6. The VRF must be accompanied by a formal letter of request addressed to:Mr. Joselito C. De Vera Executive Director Philippine National Volunteer Service Coordinating AgencyG/F Philippine Sugar Center Building, North Avenue, Diliman, Quezon City

7. Please send the original letter and VRF at the above address. Advance copy may be sent by fax at 4357999 or email a scanned copy to international@pnvsca.gov.ph. The original letter and VRF are requiredto complete the review and approval process of the request.

8. For more information, please email international@pnvsca.gov.ph or visit the PNVSCA website atwww.pnvsca.gov.ph

Revised: January 2014

Thank you for your interest to be a partner in the volunteer service program.

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A. GENERAL INFORMATION ON REQUESTING LOCAL PARTNER INSTITUTION

1. Name of Requesting Local Partner Institution:

2. Address:

Website: ____________________________ Email Address: ______________________________

3. Type of Organization

National Government Agency Non-Profit/Non-Government Organization

Academic Institution Local Government Unit Public Provincial Government

Private Municipal/City Government

International Organization

4. Mandate:

B. PROJECT/ACTIVITY TO BE ASSISTED BY THE VOLUNTEER

5. Title of the Volunteer Project/Activity: _______________________________________________

6.

7.

8.

9.

10. Status of the project/activity as of the time of voluntee

11. Duration of voluntee

REQUEST FOR VOLUNTEER Revised: January 2014

Reference Number: ________________ Ground Floor, Philippine Sugar Center Bldg., North Avenue, Diliman, Quezon CityTelefax: (632) 927-6847 • Email Address: international@pnvsca.gov.ph

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C. DESCRIPTION OF VOLUNTEER REQUESTED

12. Description of Volunteer/s Requested

Field of Specialization

Preferred Qualification No. of Vols.

Needed

Preferred date of Arrival Education Experience and

Training Vol. Sending Organization

13. Proposed Volunteer’s Work Plan (Please use the form provided)

D. SUPPORT TO BE PROVIDED TO THE VOLUNTEER:

14. Technical and administrative support:Facilities, equipment, supplies and materials Transport for project related travel

Housing

Emergency medical assistance

Others, please specify: ______________________________________________________

15. Project management team:Supervisor Name: ________________________________________

Position: _______________________________________ Contact No./Email:_______________________________

Prepared by :

_____________________________________ Name and Signature of Project Supervisor

_____________________________________ Designation

Submitted by:

_____________________________________ Name and Signature of Head of Organization

_____________________________________ Designation

Date : _______________________

ACTION TAKEN BY PNVSCA

Approved/Endorsed to _________________

Deferred due to _______________________

Disapproved due to ____________________

JOSELITO C. DE VERA Executive Director Date: _______________________

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Project/Activity:

Volunteer’s Field of Specialization:

Objectives of Volunteer

Assignment

Expected Output of Volunteer Assistance Volunteer Activities Implementation

Period

Funding Allocation & Source

Ground Floor, Philippine Sugar Center Building, North Avenue, Diliman, Quezon City Telefax: (632) 927-6847 • Email Address: international@pnvsca.gov.ph

VOLUNTEER WORK AND FINANCIAL PLAN