Application Form for an Associate Member

Name Surname
Zabala Sotes Jorge Mauricio
Place and Date of Birth D D / MM / Y Y Y Y Gender
Santa Cruz de la Sierra, Bolivia 16.08.1988 F☐ M☒
Profession / Work
Foreign language teacher / B4M Latam and Goethe Zentrum Santa Cruz
Address
Pirai Avenue, Rio Verde Street 61
Phone Email Facebook Website
+591 76634425 mzabala.sotes@gmail.com
Languages spoken
Spanish, German, Portuguese and English
Previous experience
my experience with volunteer work and non-governmental organizations
consists of a 3-month internship in Hamburg at Greenpeace Germany.

Area / type of work I would be particularly interested in helping with

Communication bridge, translation of documents and possible visits to the
on-site project in La Paz

Skills I would be prepared to share with MEDyARTE Charity

Languages.

I hereby consent to becoming an Associate Member of MEDyARTE Charity.

I read and agree to comply with the attached rules guiding Associated Members.

Place and Date………………………………………… Application approved

Signature…………………………………………………. Date:………………………………………….

Signature……………………………………

MEDyARTE Foundation Charity Number 1174295 www.medyarte.org