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APPLICATION FORM FOR INTIBUCÁ SOCCER VOLUNTEER PROGRAM

APPLICANT INFORMATION

Applicant Name: _______________________________________________

Date: __________________

School Name (if currently attending): _____________________________________________________

Company Affiliation (all applicants, please): ________________________________________________

Street Address: _____________________________________________________

City/State/Zip: _____________________________________________________

Business Phone: ________________ Home Phone: ___________________ Fax: __________________

E-mail address: __________________________________________________________________________

Please note if you DO NOT want to be called at work: _____________ Best time to call? _________

SURVEY INFORMATION:

Are you directly involved in soccer coaching? (If no, then go to question 6.)

[ ] Yes [ ] No

Describe your role(s).

What departments do you work with?

How long have you been involved in soccer?

Are you involved soccer coaching as your full time job?

[ ] Yes [ ] No

Why do you want to intern with the Intibucá Soccer Volunteer Program

Do you own a personal computer? [ ] Yes [ ] No

If yes, what kind? [ ] Mac [ ] IBM compatible

Do you have access to the Internet? [ ] Yes [ ] No

What type of work/tasks would you like to perform as part of your Intibucá Soccer Volunteer Program?

[ ] Volunteer Coach

[ ] Intern

[ ] Soccer Tourism Volunteer

[ ] Soccer Mentor

[ ] Soccer Facilities Builder

[ ] Soccer Masters Program Developer

[ ] Coach Trainer

[ ] Referee Training

Please enroll me in ______________ for ________ weeks. The total cost of this program is US$_________________

I enclose US$250 nonrefundable registration fee

I enclose the entire cost of $US ______________

Here are the three dates I would like to come to Honduras to be a Intibucá Soccer Volunteer

1st choice __________ 2nd choice ___________ 3rd choice ___________

[ ] Other: ______________________________________________

______________________________________________

For office use only:

Soccer Club Affiliation : _______________

Assigned to: _______________________________________________

Please complete and email to honducopa@yahoo.com

Payment information

Option 1 - Send money through Western Union to Honduras to CODET to La Esperanza, Intibuca, Honduras

Option Two - Send copies of the application by certified, registered mail, or DHL with payment to CODET, S de R L, Barrio El Morera, Farmacia Galencia, Frente Bazar Reyna, La Esperanza, Intibuca, Honduras

Applications can be sent by email. However it is more secure to send APPLICATIONS ACCOMPANIED BY PAYMENT. SENDING APPLICATIONS AND PAYMENT BY DHL IS PROBABLY YOUR BEST OPTION.

Option Three - Paying By Wire Transfer

Email to honducopa@yahoo.com or exportfacs@aol.com for information on sending wire transfers.

Note that your bank will charge you a fee for making this kind of transaction. This transaction fee must be paid by the party making the transaction, and not subtracted from the amount being transferred to the AfroCarib Cup, La Ceiba Football Academy, RED de AfroHeritage Footballers, ISAI or CODET. This is for wire transfers only, do not use direct deposit because we will have no way of tracking your payment.

Option Four - Paying Through PayPal

For All Programs

In order for your team's application to be processed, a team application fee and individual visa fees of US$175 each person must be received by CODET.

Soccer For Life Has A New North American Director To Head The Soccer Gear Donation Project, Shin Fujiyama. He is a student in Virginia who is already involved in volunteering in Honduras with Washington Overseas Missions and Hondukids. He will be volunteering with the Liga Menor in Honduras in August of 2005. He will be accepting your soccer gear donations at Shin Fujiyama, 6511 Machodoc ct, Falls Church, VA 22043. You may contact Shin at 703-241-0461 or Cell Phone at 702-927-8706. Email him at shinfujiyama17@yahoo.com.

More About Shin Fujiyama, New North American Director of Soccer for Life And Leader of the Soccer Gear Donation Project

Need More Information About Donating Soccer Gear, Getting Involved With The Intibucá Youth Soccer Center Or Becoming a Volunteer? Want to get involved?

More information on the Soccer Donation Project is available to you from exportfacs@aol.com. Our Soccer Donation web site is http://www.satglobal.com/donate_boots.htm. Want To Know More About The Honduras Youth Soccer Project? Email us at exportfacs@aol.com

Return to Soccer For Life Page. Participate in the Intibucá Youth Soccer Center by emailing Dr. Carol Cross at honducopa@yahoo.com or exportfacs@aol.com .

Soccer Gear Donation Program Links

The Intibucá Soccer Volunteer programs are administered by CODET, S de R L, an Intibucá based sustainable development organization. CODET has as its goal the empowerment of the youth of Intibucá through soccer. 10 percent of all above cost revenues from these vacations are dedicated to the building of the Intibucá Youth Soccer Center. An additional ten percent of the above cost revenues go to the Honduras Youth Soccer Project, with its goal the opening of youth soccer in Intibucá to the estimated 10,000 youth living in the hills of Intibucá. Remaining CODET revenues will be devoted to building a soccer stadium and state of the art mountain training facility to be used by all the youth of Intibucá.

Contact Dr. Cross at 011-504-783-0421 or honducopa@yahoo.com.

In Honduras contact:

Dr. Carol Cross or Dr. Ramon Dario Argueta

CODET, S de R L

Barrio El Morera, Frente Bazar Reyna

La Esperanza, Intibucá, Honduras

Telephone 504-783-0054

2005-2006 Honduras Soccer Team Membership & Sponsorship Available For Enrollment June 1, 2005. Make Sure You Don't Lose Your Chance. Send In Your Deposit Now! Belong To The Team As A Member Or Sponsor The Team As A Marketing Partner. We Promise To Show You A Good Time!

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