ASSOCIATION CONCORDIA

EUROPEAN VOLUNTARY SERVICE

VOLUNTEER’S QUESTIONNAIRE FOR SENDING PLACEMENTS

To begin some information about CONCORDIA…

CONCORDIA is a non-religious, non-political, non-profit-making youth exchange and volunteering association which exists since 1950.

CONCORDIA’S aims are:

-to contribute to the social life of communities by the bringing together of volunteers from different countries to work on projects which benefit the whole community.

-To promote and facilitate the free movement of people and ideas through international exchanges in a spirit of mutual understanding and peace.

-To promote informal education which encourages active citizenship and a democratic society with full participation and solidarity.

All our projects seek to achieve these aims through action and participation.

Thank-you for taking an interest in our EVS sending projects…

We are also an EVS hosting organisation.

We are not looking for highly qualified or professionally experienced volunteers but for motivated and enthusiastic young people (we believe that EVS should be accessible to all young people who wish to participate).

We believe it is important for all volunteers to have a good contact with both their sending and hosting contact persons in order to be well prepared and to get the most out of their experience.

The replies that you give us to these questions will help us to have an idea about your motivations, your expectations, your needs and your future projects.

The information you give is confidential and we will not transmit it without your consent.

NB: We don’t expect you to fill in this form in perfect English or French. Just do your best and seek help if you need it. However it is useful for us to get an idea of your language ability so don’t worry about mistakes – they won’t count against you!

YOUR SENDING ORGANISATION:

Please give the name, address, telephone and fax numbers and E-Mail address of your sending organisation as well as the name of your sending contact person in this organisation:

Reference project (in database) :

YOURSELF:

First name:

Name by which you like to be called (if different):

Last name (family name):

Gender:

Age:

Date of Birth:

Nationality:

Permanent address: (and contact address if different)

Telephone:

Fax:

E-Mail:

Who to contact in an emergency (name, relationship to yourself, and contact details):

YOUR PRESENT SITUATION

(please put a tick or cross after the correct replies):

I live:

With one or both parents

Alone

With a friend or friends

In shared accommodation

Other (please state)

In a city or large town

In a semi-urban area

In a small town in the country

In a small village or isolated rural area

Other (please state)

My present situation

I am still at schooluntil:

I am a studentsince:

I am unemployedsince:

I have paid worksince:

I am in trainingsince:

I am a volunteersince:

Other (please describe)

YOUR LIFE EXPERIENCES:

Have you already travelled or lived abroad?

If «yes» where, when, for what reason and for how long?

Have you already participated in any voluntary or associative activities?

If «yes» where, when, for how long, what type of activity and with which organisations?

Which languages do you speak and to what level? (please list the languages and state the level)

Level 1: Mother tongue or bilingual

Level 2: I understand and speak well

Level 3: I can manage quite well speaking and understanding

Level 4: I have a basic knowledge and can hold a simple conversation

Level 5: I have some very basic vocabulary

What do you like to do with your free time in general / what sort of things are you interested in? (activities and personal interests)

Have you done any studies or training courses? Please give approximate dates, the type of course and the subject matter. (or attach your CV if this is easier!)

Do you have any professional experience? Please give approximate dates length of service, type of work (or attach your CV)

Other skills, things that you’re good at or like doing….

Do you have a driving licence?

If «yes» do you drive a car regularly?

YOUR EVS PROJECT:

Please give a short description of yourself, your background, your life at the moment, your tastes, past experiences and future plans :

Why would you like to take part in EVS ? Why now ?

In what way do you think you would be able to contribute to your chosen host project and more generally to the Programme as a whole ?

In what way do you think you will benefit from the experience ? What are your personal objectives and future plans ?

What would your definition of volunteering be ? What values do you attach to it ?

Have you ever shared accommodation before ? What do you consider to be the rights and responsibilities of those sharing a house or bedroom ?

Which themes are you most interested in for your EVS project: (please mark one or more replies or put in order of preference)

Health & medical

Social integration and social exclusion

Environment

Rural communities

Equal opportunities

Art and culture

Media and communication

Immigration

Children and young people

Local development (urban / rural)

Heritage, historic monuments and tradition

Sports and leisure

Anti-xenophobia

Elderly persons

Disabled persons

Homeless persons

Unemployment and unemployed persons

Crime prevention

Youth information

Politics and youth

European awareness

Do you like? (please choose one or more replies or put in order of preference)

Heavy manual work

Light manual work

Working outdoors

Daily contact with the public

Team work

Intellectual work

Working alone

If you had the choice would you prefer a project (please choose one or more replies or put in order of preference)

In a city or large town

In a suburban area

In a small town or village

In an isolated rural situation

What would be the ideal length of your project (please choose one or more replies or put in order of preference)

Up to 1 month

1 – 3 months

3 – 6 months

6 – 9 months

9 – 12 months

From which date are you available?

Is there a date before which you need to finish your project (because you have a job or course to begin for example)?

If you had the choice which sort of accommodation would suit you best? (Please mark one or more replies or put in order of preference):

Sharing accommodation with a group (up to 4) of volunteers

Living in an accommodation centre

Living in accommodation attached to your work-place

Living alone and independently

Living with a family

Having your own bedroom

Sharing a bedroom

Cooking for yourself

Meals provided

Do you have any special needs or requests that you would like us to take into consideration? (eg: do you need regular medication or medical follow-up, special dietary needs, family considerations, exams or interviews that will take place while you are away, holiday requests…)

NB: We do not ask this question in order to exclude volunteers who may, for example, have a health problem but in order yo be able to put in place the necessary arrangements so that this is dealt with correctly and openly.

Do you have any worries or apprehensions about becoming an EVS volunteer? What challenges do you think you will face?

What do you plan to do after your EVS project?

And finally…

How would you describe yourself?

We have listed some key words that may help you to describe yourself. Please underline the words which seem to describe you the best and add other words if you wish. You may like to ask a friend to help you.

extrovertintrospectivefun-lovingadventurousnoisyuntidystudious

musicalartisticleadereasy-to-pleaseshyorganised

moodypatientdancerreaderfollower listener

talkativeindependentquiettidyearly-to-bedflexible

religiousathleticforthrightworrierconfident prudent

caringstubbornparty-goeremotionallacking confidence

Would you like to add anything else? Do you have any questions?

How did you hear about EVS?

How did you hear about CONCORDIA?

Your Signature:

Date:

CONCORDIA Aquitaine

14, Rue de l’Eglise

33880 ST CAPRAIS DE BORDEAUX

France

Tel: 00 33 556 78 76 46

Fax: 00 33 556 78 76 47

E-Mail:

Some useful information:

The team members at CONCORDIA Aquitaine are:

Gaëlle DAHERON (Regional Manager: speaks French and English)

Frédéric Vasco (EVS Coordinator: speaksFrench, English, Spanish and Portuguese)

DEADLINES:

Starting date of project Date limit for reception of funding applications

1st December onwards1st September

1st February onwards1st November

1st May onwards1st February

1st July onwards1st April

1st September onwards1st June

PREPARATION, TRAINING and EVALUATION

On-arrival training will take place shortly after your arrival. The training includes an introduction to the language and culture, lasts 10 days and brings together a group of EVS volunteers coming to France.

Mid-term evaluation about 3 days.

Final evaluation