Good choice! You are going to absolutely love working with Gap Chile and are going to genuinely help so many people. We are really grateful you share our desire to help people in Chile and are sure you will not regret this. Just fill out this form and we will be in contact to arrange an interview. Don’t worry if you don’t live too near, we can do it over Skype as well. If you have any questions just use the form on the right.

1. Personal Details

Surname*

Fornames*

Date of birth* Day/Month/Year

Nationality*

Photo of yourself* - max 5mb - the bigger this is the longer it will take to submit so please be patient


2. Contact Details

Contact Address* (Town/City,Country, Postcode)

Telephone/Mobile*

Email*


3. Experience and Skills

What are your reasons applying for this placement?

What are your plans after your year out?
 Go to university Go to a career Other

Can you speak another language?

If yes, Which one?


4. Personal History

Have you any medical disorders?
 Yes No

Are you taking any regular medication?
 Yes No

Have you any allergies?
 Yes No

Have you any dietary requirements?
 Yes No

Have you a previous criminal record?
 Yes No


5. Referee

(please ask your referee before nominating them)
You must referee from your school, university or employer

Name of Referee

Title

Address

Tel/Mobile Number

Email


6.Placement

When is your preferred day of departure? Day/Month/Year

What is your planned length of placement?


7. Declaration

I declare that the details completed on this form are true and accurate.