EmailMe Form - Form 3: Bridging Lanka Volunteer Placement Details

Form 3: Bridging Lanka Volunteer Placement Details

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Congratulations and welcome on board!

Your volunteer placement with Bridging Lanka in Mannar is getting closer. Now we need more detailed information about you and your travel plans to make your stay comfortable and effective. Please answer the questions below.

Please note that to submit this form, you will need to either:
- Complete ALL parts of this form at the one time and click on 'Submit', or
- Click on 'Save & Resume' then return to complete at a later time.

To complete this form, you will need the following:

1. Confirmed return ticket to enter into Sri Lanka;

2. An address in Sri Lanka. If staying in Colombo: the name and address of a hotel, guesthouse or other accommodation. If coming directly to Mannar: "48 New Moor St, Mannar";

3. Valid 30 day entry visa. A fast online visa is available from www.eta.gov.lk and costs approximately US$35. Do not apply for a visa anywhere else as other sources may be unreliable. A visa can be extended for up to six months in Colombo. For “purpose of visit”, select option for “sightseeing or holidaying” or “visiting friends and relatives”.

4. Travel insurance - you will require cover for the entire period in Sri Lanka. One option is World Nomads - http://www.worldnomads.com.au/travel-insurance/ but we recommend that you seek advice for insurance specific to your needs.
You will be asked to sign a form to authorise Bridging Lanka to contact your travel insurance provider on your behalf if for any reason you are unable to do so.

5. Medical travel advice from a health professional. As a minimum, ensure that your Tetanus and Hepatitis A vaccinations are current.

6. Paid the AU$300 (waged) or AU$200 (unwaged) fee to cover the cost of BL staff and office support during your stay. You can transfer to the BL account ahead or pay cash on arrival.
Name: Bridging Lanka Ltd
Bank: Commonwealth Bank of Australia
BSB: 063010
Account No.: 11837067
Please add your name and 'admin' in the description.

Your personal information will only be used by Bridging Lanka to arrange your volunteer placement and will not be given to a third party.

If you need any further information, please contact us at info@bridginglanka.org or check out our website www.bridginglanka.org

Section 1: Your contact details while in Sri Lanka
Name on passport *
First Middle Last
Enter exactly as shown on your passport
Email *
Mobile/Cell Phone Number *
Include country code for all phone numbers
e.g. for Australia +61 and remove first 0
Example +61 423 567 890
Sri Lanka Phone Number
(If you already have one - otherwise you can arrange a phone and/or local sim card on arrival.)
Section 2: Your travel details
Passport Information *

Passport Number

Country of Issue

Place of Issue
Date of Birth *
DD / MM / YYYY
Passport Date of Issue *
DD / MM / YYYY
Passport Date of Expiry *
DD / MM / YYYY
Please upload a recent passport sized photo
Flight Number - Arrival to Sri Lanka *
Flight Details - Arrival to Sri Lanka *
DD / MM / YYYY HH : MM AM/PM
Flight Number - Departure from Sri Lanka *
Flight Details - Departure from Sri Lanka *
DD / MM / YYYY HH : MM AM/PM
Electronic Travel Authorisation (ETA) - online visa number
You need a visa for arrival to Sri Lanka - please confirm with your travel agent, Sri Lankan government resources or contact us for more information.
We strongly recommend arranging your visa well in advance of your travel.
Visa Expiry Date
MM / DD / YYYY
Travel Insurance *

Provider Name

Policy Number
Travel Insurance Start Date *
MM / DD / YYYY
Travel Insurance Expiry Date *
MM / DD / YYYY
Accommodation on arrival in Sri Lanka
Please add name & address of accommodation: *
You will need to complete this on arrival for immigration documentation.
If you do not have accommodation booked yet, please update Bridging Lanka before departure.
Section 3: Your placement in Mannar
Bridging Lanka will use this information to confirm volunteer accommodation, work schedules, tourism and other logistics. If travel plans change, please advise us so that we can ensure we are ready for your arrival.
Expected arrival to Mannar *
DD / MM / YYYY
Expected departure from Mannar *
DD / MM / YYYY
Please add at least the expected dates according to your plans.
Would you like us to arrange transport to Mannar? *
Yes, please arrange - prefer A/C overnight bus; 7hr $10
Yes, please arrange - prefer train, 9hr $4
Yes, please arrange - prefer van, 6hr $160
I will arrange transport to Mannar and advise you
I have arranged transport (please add information below)
Please confirm that your volunteer fee has been paid: *
Yes, bank transfer paid
No, I will pay cash on arrival
Other
AU$300 waged or AU$200 unwaged, via bank transfer details above.
Accommodation in Mannar

Bridging Lanka will arrange accommodation on your behalf based on the preferences below: *
Simple guesthouse with fan
Luxury guesthouse with fan
Simple guesthouse with A/C
Luxury guesthouse with A/C
I have arranged accommodation (please add information below)
All rooms have fans but extra cost for A/C)

If you are returning to Mannar and prefer a specific guesthouse, please add the name in the comments section at the end of the form.
Section 4: Volunteer requirements
Health & Wellbeing *

Any special dietary requirements?

Any allergies?

Any medical conditions?

Any other information we should know?
Next of Kin *

Full Name

Contact phone including country and area codes

Address

Relation to you (e.g. father, wife)

Email
Release, Waiver and Indemnity
I hereby agree to all parts of the Assumption of Responsibility as listed below.
I hereby release and waive as against the Released Parties any and all losses, damages, injuries including death, claims, demands, lawsuits, expenses including legal fees and disbursements, and any other liability of any kind, directly or indirectly.
I have read the 'General Information and Requirements for Volunteers Information Sheet' and agree to comply with the requirements set out in that document as part of agreeing to undertake a volunteer placement in Sri Lanka with Bridging Lanka.
This agreement covers the total period of my volunteer placement with Bridging Lanka in Sri Lanka.
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ASSUMPTION OF RESPONSIBILITY

I understand that participation in a field visit will take me away from a familiar environment to unfamiliar surroundings and therefore will be exposed to risks to my person and possessions.

I acknowledge that there may be certain dangers inherent in undertaking field work in international settings where there may be significant risk. I agree to take the risks associated with such locations. I will abide by all applicable Bridging Lanka instructions as outlined in the document, “Bridging Lanka General Information and Requirements for Volunteers”, together with the laws of the host country, and I will ensure that I have adequate medical and travel insurance coverage, including for my personal possessions.

More particularly, I appreciate that Bridging Lanka does not carry accident or injury insurance for my benefit and also that there may be certain matters for which I could be held at fault personally if the accompanying circumstances do not relate to or arise from my field visit or if my activities or conduct fall short of what would be considered a reasonable standard for an individual in my position. In these cases I will be personally accountable in all respects for my own actions and not to ask that Bridging Lanka, its Board of Directors, employees, and agents (the “Released Parties”) to accept the consequences thereof.

I acknowledge that I have been advised by Bridging Lanka of such risks, dangers and hazards as well as the need to act in a responsible manner at all times. My consent above is given freely in order to indicate my understanding of the acceptance of these realities and in consideration for being permitted by Bridging Lanka to participate in this field visit. I recognize that Bridging Lanka will not supervise any of the living arrangements or extracurricular activities during the field work period.
Please upload your electronic signature here to indicate your agreement above.
If you cannot upload your signature here, you can sign this form when we see you next.
We look forward to welcoming you in Mannar soon!

Thank you for your commitment to joining Bridging Lanka.

If you have any further questions or comments, please add them below.

Any special dietary requirements?
Any allergies?
Any medical conditions?
Any other information we should know?

Full Name
Contact phone including country and area codes
Address
Relation to you (e.g. father, wife)
Email

Passport Number
Country of Issue
Place of Issue

Provider Name
Policy Number

Section 1: Your contact details while in Sri Lanka

Section 2: Your travel details

Section 3: Your placement in Mannar

Section 4: Volunteer requirements