© 2011 Vodacom (Pty) Limited.

Change the World

Vodacom Change the World – Application Form

Have the following documents ready to upload:
  1. A copy of your ID.
  2. Two recent electronic photographs of yourself (1 head and shoulders and 1 full length on a white background - these will be used in all publicity, so you should be comfortable with the image).
  3. Two references that include contact details. (1 personal and 1 professional).
Upload a copy of your ID
(Required Only pdf, jpg, gif or png files allowed)
Upload electronic photograph of yourself (1)
(head and shoulders)
(Required Only jpg, gif or png files allowed)
 Upload electronic photograph of yourself (2)
(full length on a white background)
(Required Only jpg, gif or png files allowed)
Personal reference:
(pdf, Word, Excel or text files only)
 Professional reference:
(pdf, Word, Excel or text files only)
 
By submitting your application you confirm that you have read, understand and agree to accept the Terms and Conditions of Vodacom Change the World. Click here to view.
I accept the T&C
 
PERSONAL DETAILS
Name:
Surname:
Age:
ID number:
Gender:
Female   Male		 Contact number:
E-mail:
Alternative number:
Postal address:
Residential address:
Valid driver's license?
Yes   No		 Own transportation?
Yes   No
Any disability?
Yes   No		 Hobbies and interests:
(if Yes please provide further information):
Have you ever been the subject of public allegations, under investigation, charged, prosecuted, or convicted, or had your assets been seized, blocked, frozen or ordered forfeit or has a judgment been entered against you in respect of any national, foreign or international law relating to corruption, money-laundering and terrorist financing?
Yes No
If yes, please provide details
 
EMPLOYMENT HISTORY
Employment status:
 IF UNEMPLOYED/RETIRED/RETRENCHED:
When was last formal employment position held?
 IF EMPLOYED:
Current employer:
Current position:
Income tax number:
 

Current salary:
R0 - R5 000

R5 000 – R10 000

R10 000 – R15 000

R15 000 – R20 000  

R20 000 – R30 000  

R30 000 plus
 
EXPERIENCE/ QUALIFICATIONS
What qualification do you have that will make you a preferred volunteer for your chosen NGO?
Do you belong to a professional association/ body?
Yes   No		 If yes, which association do you belong to?
Membership number (if applicable):
Provide details on previous experience, if any, of volunteering or community work?
 
GENERAL
How did you hear about the Vodacom Change the World Program?
What motivated you to apply for this particular initiative?
If successful, would your current employer provide a letter, releasing you from duty for a period of 6 months?
Yes   No
 
NGO SELECTION
Please tick the NGO volunteer opportunity you selected:
Province Organisation Skills Required
KwaZulu Natal 1000 Hills Community Helpers Pre-School Educator
Free State Free State Care in Action Volunteer Coordinator
Mpumalanga SANCA Lowveld Social Worker
Northern Cape Business Against Crime South Africa Social Worker
Western Cape Ikamva Labantu General Medical Practitioner
Eastern Cape East London Child and Youth Care Remedial Educator
North-West Opkyk Pathways Therapy and Education Centre Speech Therapist
Limpopo Waterberg Welfare Society Marketing / Fundraising
Gauteng Sizanani Children's Home Occupational Therapist
Gauteng SPCA Sandton Marketing / Fundraising
What motivated you to select this particular NGO and volunteer opportunity?
If your application should be successful, what would be the 3 goals you would like to have accomplished at the end of your 6 month Vodacom Change the World placement?
Do you or any family member have a current relationship with the NGO?
 
GOVERNANCE
Legal and CMT Questionnaire Yes No
Are you a government or political official?
If yes, please provide details as an attachment:
(pdf, Word, Excel or text files only) 		 Yes  No
Do you have any family or close business relationships with any government or political official?
If yes, please provide details as an attachment:
(pdf, Word, Excel or text files only) 		Yes No
Were you referred to the program by a Government or Political Official?
If yes please provide details as an attachment:
(pdf, Word, Excel or text files only) 		Yes No
 
The top 20 shortlisted candidates will need to make themselves available for an assessment in February 2011. Please note that the answers provided in this application form are legally binding. The information will be used internally by Vodacom for governance and other business purposes, and may further be used as evidence in any audit, investigation or administrative or judicial proceeding in respect of the matters concerned. Vodacom reserves the right without further recourse to verify at Vodacom's cost any fact provided in answer to any of the questions.

By entering this competition, applicants confirm that the Vodacom Foundation, members of the Vodacom Group and our appointed agents, have the right to use each successful applicant's entry, updates and reports (including written, audio and visual forms) and any photos, videos or personal details and other publicity materials at its absolute discretion for promotional and reporting purposes without any remuneration to the applicant. By submitting an entry, each applicant unconditionally and irrevocably assigns all rights; title and interest in all copyright and all other intellectual property in any material provided to the Foundation and waives all moral rights in any material provided to the Foundation. The applicant shall not knowingly or negligently engage in transactions that violate South African laws relating to corruption, money laundering and terrorism and to this end the applicant shall comply with all applicable South African laws.