Life Savers

Membership Application

General Information
Name:  
Date of Birth:  
Gender:  
Contact Address:  
Phone:  
Email:    
Field(s) of Study
Course(s) University/Institute Degree/Diploma Year
Work Experience
Responsibility Company Brief Description of Work Length in Weeks/Year
Involvement with any other social initiative
NGO/Student Organization Brief Description of Work Length in Weeks/Year
Language Skills
(Native/Excellent/Good/Basic)
Language Speaking Understanding Writing-Reading Overall
Computer Skills (Basic/Good/Advanced)
Internet User Skills:  
PC User Skills:  
Have you ever helped a road accident victim?  
If not, specify the reason:
Not skilled in basic life saving
Fear of getting caught and harassed by the Police
Were in a hurry
Any Other (Please specify)
How many hours can you commit to SaveLife Foundation in a week?  


How do you get to know about SaveLife Foundation?  


Others:
Do you have any immediate committments in the next one year? If yes, mention briefly.