States Parties 161 States Not Party 36
All information in this application form will be kept strictly confidential. (If handwritten, please print clearly.)
First Name:___________________________ Last Name:___________________
Occupation:_____________________________ Full Time: ___ Part Time: ____
Address:___________________________________________________________
City:______________________________ State or Province:________________
Zip Code:__________________________________________________________
Country:___________________________________________________________
Home Phone:__________________________ Work Phone: __________________
Fax:______________________________ E-Mail:__________________________
How many hours per week are you available to volunteer:___________________
What days per week would you prefer to volunteer:________________________
Please state your days and hours of availability: ___________________________
____________________________________________________________________
Are you able to commit to volunteering with the ICBL for a minimum of 3 months:
Yes __ No, and if not why?____________________________________________
General Information
How did you hear about ICBL?_____________________________________________________________
Why do you want to volunteer with ICBL?________________________________________________________________
______________________________________________________________
Fluent in:
Native Language: ___________________ Willing to translate from ______________________ into ________________________
Please translate the following paragraph into each language that you are fluent in:
ICBL Youth Ambassador and Cambodian landmine survivor Song Kosal started the Youth Against War Treaty in 1998. From 1998-2001, youth in 42 countries collected over a quarter of a million petition signatures, urging the United States government to join the Mine Ban Treaty. These signatures were delivered to the Bush administration in March 2001.India and Pakistan have been chosen as the new Youth Against War Treaty targets. Both countries have used landmines in three wars with each other and recently planted landmines along their shared border. The media has reported both civilian and military casualties from these newly planted mines.
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Please e-mail, fax, or send your application to:
International Campaign to Ban Landmines 9 Rue de Cornavin CH-1201 GenevaSwitzerland
Email: icbl@icbl.org
Tel: +41 (0)22 920 03 25Fax:+41 (0)22 920 01 15
