Global Crossroad application volunteer in Cambodia: Cambodia is a country of substantial contradictions. Despite a tumultuous and violent past and lingering poverty, Cambodia retains it undeniable charm and glory. The beautiful capital city of Phnom Penh contains many attractive and impressive temple monasteries known as wats, and the surrounding villages, which are quaint with friendly residents and a tropical climate places Cambodia as one of the major tourist destinations in Asia.

1. Application for Volunteer Program: Cambodia
Step 4
Application Steps:
Step 1 Once you get confirmation of your project(s), your host
family (or other arrangements of room and food), and local
Once Global Crossroad receives your email, we contact addresses, you should start preparing for travel and
will reply back with answers to your questions. obtain all necessary documents (passport, visa) and
A formal application will be attached or you can immunization requirements.
download a formal application form our website
or apply online.
Step 5
Step 2
Complete the application form and submit it Once you have purchased your ticket, please fax a
with a non-refundable US$200 application fee photocopy of your passport and itinerary to our office.
(check/money order/credit card). The
application fee is deducted from the total Step 6
program fee. Global Crossroad Guarantees
placement, if not we refund a program deposit Pay full program fee at least 2 months in advance, You
of 200.00 USD arrive to host country, our coordinator receives you, and
program starts
Step 3
After receiving your application and $200
application fee, we will notify you immediately Please complete, sign, and fax or mail this application your
and your application will be processed. Please nearest office location:
allow us 1-2 weeks to process your application,
match your interest, and come up with the USA: Dallas (Irving) office
details of your project, arrangements for room
and food, and answer your questions. Global Crossroad
4425 W Airport Freeway, Suite 210
Irving, TX 75062
Fax: 972-852-7999
Personal Details
Last name First name
Home Address Mailing Address:
Phone (Home) e-mail of applicant
Phone (Mobile)
Date of Birth
Sex
Nationality Passport number

2. Emergency Contact Address (must complete name, relationship, address, email and telephone number)
Please Select your first and second project of choice (please write)
First priority project:
Second priority project:
Program start date (please write month and year)
(1) First Monday of __________
(2) Third Monday of ___________
Length of stay in weeks (please write): _________
Additional Information
Please explain your motivation for participating Global Crossroad volunteer program:
Please explain your educational background and relevant experience:

3. Explain a time in your life when you had to go beyond your comfort zone:
Are you in good health for traveling and volunteer work? Please explain if you have any medical conditions.
If you have any concerns or questions please mention here:
Do you have any referrals or discount coupons? If yes, please write the number code
By signing here, I acknowledge that I thoroughly read all Global Crossroad terms and conditions (please
visit http://www.globalcrossroad.com/termsandconditions.php) for my placement. I hereby agree
on all the terms and conditions given by Global Crossroad, including the organization’s responsibilities, my
responsibilities, my liability waiver, and the termination conditions of my volunteer program. I understand
everything that I have read, and I will fully abide by all of Global Crossroad’ terms and conditions.
Signature: Date: / /
Payment information:
I would like to pay my program deposit of USD 200.00 by using
a) Cheque (please attach with application)
b) Bank transfer (please fax the receipt)
c) Credit card (we accept VISA and Master only)
Card type (please check): 1) visa 2) Master
Card number:

4. Would you like pay your full amount by using credit card?
a) Yes
b) No
If yes please write USD= …………
Card Expiry date:
CBS number (last 3 digit number in the back of credit card) ____________
Card Holder name:
Address:
Signature: Date: / /
Official use only:
Name:
Placement:
Departure date:
Nationality:
Name of Placement