FOR OFFICE USE ONLY Assignment ID

CONFIDENTIAL
Date.................................. Manager........................... Occ................................... Fund................................. DAC Code........................

Approved.................................... Client ID..................................... Ind.............................................. Cat.............................................. AusAID KRA...............................

Task............................................................................................

Rep/Agent...................................................................................

CONFIDENTIAL

Application for an ABV Volunteer

This application should be completed in consultation with the ABV In-Country Manager or Agent. All questions must be completed. Please either complete on the computer or use a black pen and print clearly.

Contact Details
First Name Arum Wardhani Family Name Position

Name of organisation seeking an ABV volunteer Contact person Male Female Street Address Postal Address Town / city Telephone (w) Facsimile Email #1 Website Volunteers supervisor Male Female Title Preferred Name + + + Title Preferred Name

Wardhani Lecturer

Country Telephone (h) Mobile phone Email #2

First Name

Family Name Position

If the Assignment location is different to the address above, please write the address below:

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CONFIDENTIAL B Background about your Organisation

Mission of Organisation

Private

Government

NGO

Community Group

Other

Main activity

Number of staff /employees /helpers Annual budget and turnover

78 Peoples Year organisation started 1994

Do you have a strategic or business plan?

Yes (please attach to this application) No

Please provide background information about your organisation.

Please describe in detail the problem for which you are seeking an ABV volunteer.

Which other aid agencies have you contacted for this particular assignment?

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CONFIDENTIAL C The Assignment

These questions are intended to describe the assistance you require from an ABV Volunteer. The more information we have, the better able we are to assist you. If insufficient room is provided below, please attach additional information. All ABV assignments are based on skills exchange and capacity building of local staff and the Volunteers Tasks below should reflect this. 1. Goal What is the overall goal of the assignment for which you are seeking ABV assistance?

2. Objective(s) What do you want the assignment to achieve for your organisation and/or community? List (a maximum of) 4 objectives that the assignment is aimed at achieving: Objective 1

Objective 2

Objective 3

Objective 4

3. Volunteers Tasks Please describe the staff training and tasks that you would like the Volunteer to do in order to achieve the objectives listed above. Task 1

Task 2

Task 3

Task 4

Task 5

Task 6

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4. Outputs What will be the result of carrying out the tasks listed above? These include the results of training your staff or documentation such as guidelines, manuals and procedures. Output 1

Output 2

Review and make recommendations regarding cost center allocation and the ability of the fee system

Output 3

Output 4

5. Counterpart Staff The following information about the staff you would like to receive training will assist ABV and the Volunteer to understand the counterparts current skills and training needs. Full Name Position (what do they currently do?) Time in current position Formal education and training Training required

6. The Volunteer What qualifications, skills and experience does the volunteer need to have? Qualifications Experience Other

7. Duration/timing of Assignment It may take up to 3 months to find and place the volunteer. What period of time would the volunteer be required for the Assignment?

mm / yyyy

What date would you like the volunteer to start on?

dd

8. Machinery/Equipment ABV does not provide any equipment, software or computers. (a) If the assignment requires computers, software, systems, machinery and/or equipment, please describe what you already have, e.g. Type, Brand, Model, Size/Capacity, and Age. (b) Is it operational?
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CONFIDENTIAL
(c) If equipment needs to be purchased and installed, or repaired, when will this be done?

9. Language What language is spoken by the local community and the people the volunteer will be working with? Is English readily used by the local community and the people the volunteer will be working with? If English is not understood an interpreter must be provided. Can you provide an interpreter if required? Yes No

Yes No

Funding / Client Contribution

1. Clients Contribution to the Assignment (in local currency where appropriate) ABV Assignments are partnerships between your organisation and ABV. What contribution can you make to this assignment? Accommodation* Living Allowance Airfare Other (for example transport costs) TOTAL

*Can be the value of in-kind contribution, i.e. providing accommodation of X value.

E
Name

Authorisation
dd / mm / yyyy ABV ICM/Agent Signed Date dd / mm / yyyy

I have read and agree with the information contained in this application.

Position Signed Date

The ABV In-Country Manager or Agent will submit this application to ABV Head Office. You will be notified in writing when this assignment has been approved.

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CONFIDENTIAL Attachment A Accommodation requirements for ABV volunteers

ABV volunteers may be accommodated in a hotel, a furnished apartment or a furnished house, but whatever is chosen by the client must be approved as suitable by the ABV In-country Manager or Agent before the volunteer leaves Australia. Clients should bear in mind that the volunteer may be accompanied by a partner. In all cases accommodation must be clean and waterproof with sound walls and floors. Window should be insect-screened and curtained, and the accommodation must be secure with locks on the doors. There must also be lights (electric/gas/kero). It is recognised that there may be difficulties in providing accommodation which meets all the requirements. If so the problem should be discussed with the local ABV In-country manager or Agent. Hotel The hotel must be clean, comfortable and secure. The room should be air conditioned or have ceiling fans. There should be a self-contained bathroom with hot and cold running water in the shower or bath and a toilet. A small refrigerator should be provided as well as tea and coffee making facilities. There should also be a table and two chairs. Where the Client is paying for accommodation, the hotel account for the room, service charge and taxes should be paid directly to the hotel by the client company. Personal items such as international telephone calls, mini bar or room service are the responsibility of the volunteer. Furnished apartment or house Where the Client is paying for accommodation, the client should accept and pay direct accounts for electricity, water, gas, garbage collection and local telephone. It should be air conditioned or have adequate ceiling fans. Apartments should include a bedroom, living room, kitchen and bathroom. A furnished apartment without cooking facilities may be acceptable if there are inexpensive restaurants. Tea and coffee making equipment and a refrigerator are essential items. Checklist: clean and in good repair waterproof with sound walls and floors window coverings secure with locks on doors lights (electric/gas/kero) separate bedroom/kitchen/bathroom/toilet hot and cold running water refrigerator gas or electric cooker toaster and jug cooking utensils and plates and cutlery, etc table and chairs comfortable chairs or sofa beds with mattress, pillows, sheets and towels air conditioning or fans cleaning equipment including mop, bucket, broom and detergents start up kit of milk, tea, coffee, sugar, bread, butter, jam, cereal, fruit or vegetables wardrobe.

A television and/or radio if available would be greatly appreciated by the volunteer.

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