Application Form ✻ Be sure to read our Get Started page before applying! * Mandatory fields Part 1 — Profile Personal Details * Full Name (as per IC / Passport) GenderMaleFemale Contact Number Must be contactable via WhatsApp. Please include country code, i.e. +601212345678 Email Address IC Number / Passport Number Mailing Address Which State Are You Currently Living In? ---SelangorKuala LumpurMelakaKedahPulau PinangPerakNegeri SembilanPahangJohorSarawakSabahTerengganuKelantanPerlisLabuan Nationality ---MalaysiaSingaporeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote D'IvoireCroatia (Hrvatska)CubaCyprusCzech RepublicCzechoslovakia (former)DenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea (North)Korea (South)KuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNeutral ZoneNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSlovak RepublicSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmirateUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUSSR (former)UzbekistanVanuatuVatican City State (Holy See)VenezuelaVietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and Futuna IslandsWestern SaharaYemenYugoslaviaZaireZambiaZimbabwe Date of Birth Current Age Passport Size Photo CV (Optional) Secondary School Education Note: Not mandatory. Only applicable for applicants currently in secondary school. Name of School Expected Graduation Date ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember---20302029202820272026202520242023 Location of School Major (Biology, Physics, Chemistry, Economics, etc) Current Education * Please add your current education qualifications Institute / University Graduation Date ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember---203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001 Qualification (Eg: Bachelor of, Diploma in, O-Levels, A-Levels, IBDP, PMR, SPM etc) Institute / University Location (Country) Major Grade (Current / Final Semester) Languages *Proficiency level: 1 - Poor, 10 - Excellent Language Spoken Written English ---12345678910 ---12345678910 Bahasa Malaysia ---12345678910 ---12345678910 Part 2 — Volunteer Experience Please take note of the following: There is no fee to join the RASMA program although some partner organisations do operate in remote areas where food and accommodation are provided at the volunteer's expense. Please read to see which partner organisations require you to cover your own expenses. You are allowed to volunteer at a maximum of three (3) organisations. We will endeavour to do our best and match you to your preferred organisations. However, the final decision will be based on availability and confirmation from our partners. As you select your organisation, please do consider your availability with regards to your school/university schedule, family commitments and the schedule of the organization of your choice 2 days / week minimum is required for online work Please indicate your preferred commitment type (or Award Level) for Roots & Shoots Malaysia Award *: 1-Star (45 Hours)2-Star (55 Hours)3-Star (75 Hours) How long would you be available for volunteering? ---2 Weeks3 Weeks1 Month2 Months3 Months4 Months How many organisations would you like to volunteer in? ---123 Please select up to three (3) of your preferred organisations to volunteer for the Roots & Shoots Malaysia Award *: 1st Choice: ---Abundant Ventures Sdn BhdAurecon Lestari Sdn BhdBiji Biji Design Sdn BhdBornean Sun Bear Conservation CentreDanau Girang Field CentreEats, Shoots & RootsFashion Forward FutureFree Tree Society Kuala LumpurGeneration ChangeGibbon Conservation SocietyPemimpin GSLLangur Project PenangMajlis Kanser Nasional (MAKNA)Malaysian Primatological SocietyMereka Innovative Education Sdn BhdNakawan ExplorerNight Spotting ProjectNuvista Media Sdn BhdPearls of PerlisPerak State Park CorporationPersatuan Aktivis Sahabat Alam - KUASAPersatuan Kebun Komuniti TTDIPersatuan Pelindung Harimau MalaysiaPULIHARA - InternshipPULIHARA - VolunteerPetFinder.myRimba Ilmu Botanic GardenRoots & Shoots MalaysiaTanoti Sdn. Bhd.The Datai PledgeThe Habitat FoundationTRCRC - Elmina Rainforest Knowledge Centre Outreach ProgrammesTRCRC - Tropical Rainforest Living Collection Merisuli SabahTurtle Conservation Society of MalaysiaWater Watch PenangWetlands InternationalYouths United for Earth (YUFE) 2nd Choice: ---Abundant Ventures Sdn BhdAurecon Lestari Sdn BhdBiji Biji Design Sdn BhdBornean Sun Bear Conservation CentreDanau Girang Field CentreEats, Shoots & RootsFashion Forward FutureFree Tree Society Kuala LumpurGeneration ChangeGibbon Conservation SocietyPemimpin GSLLangur Project PenangMajlis Kanser Nasional (MAKNA)Malaysian Primatological SocietyMereka Innovative Education Sdn BhdNakawan ExplorerNight Spotting ProjectNuvista Media Sdn BhdPearls of PerlisPerak State Park CorporationPersatuan Aktivis Sahabat Alam - KUASAPersatuan Kebun Komuniti TTDIPersatuan Pelindung Harimau MalaysiaPULIHARA - InternshipPULIHARA - VolunteerPetFinder.myRimba Ilmu Botanic GardenRoots & Shoots MalaysiaTanoti Sdn. Bhd.The Datai PledgeThe Habitat FoundationTRCRC - Elmina Rainforest Knowledge Centre Outreach ProgrammesTRCRC - Tropical Rainforest Living Collection Merisuli SabahTurtle Conservation Society of MalaysiaWater Watch PenangWetlands InternationalYouths United for Earth (YUFE) 3rd Choice: ---Abundant Ventures Sdn BhdAurecon Lestari Sdn BhdBiji Biji Design Sdn BhdBornean Sun Bear Conservation CentreDanau Girang Field CentreEats, Shoots & RootsFashion Forward FutureFree Tree Society Kuala LumpurGeneration ChangeGibbon Conservation SocietyPemimpin GSLLangur Project PenangMajlis Kanser Nasional (MAKNA)Malaysian Primatological SocietyMereka Innovative Education Sdn BhdNakawan ExplorerNight Spotting ProjectNuvista Media Sdn BhdPearls of PerlisPerak State Park CorporationPersatuan Aktivis Sahabat Alam - KUASAPersatuan Kebun Komuniti TTDIPersatuan Pelindung Harimau MalaysiaPULIHARA - InternshipPULIHARA - VolunteerPetFinder.myRimba Ilmu Botanic GardenRoots & Shoots MalaysiaTanoti Sdn. Bhd.The Datai PledgeThe Habitat FoundationTRCRC - Elmina Rainforest Knowledge Centre Outreach ProgrammesTRCRC - Tropical Rainforest Living Collection Merisuli SabahTurtle Conservation Society of MalaysiaWater Watch PenangWetlands InternationalYouths United for Earth (YUFE) We take the health and safety of our volunteers seriously and are trying our best to coordinate with our partners to provide online volunteering opportunities. Some examples of online volunteering include graphic design, merchandise design, social media management, research work, data entry, web development, outreach, online fundraising, organising webinar or virtual tours, grant application writing, organising online workshops, tech support, etc. As a future volunteer, would you be interested in volunteering online? ---Yes, I'd prefer online onlyNo, I'd prefer on-site onlyI'd prefer both online and on-siteI'd prefer either online or on-site Have you read and understood the information listed regarding the organisation of your choice? Please take note of the location, schedule, programme and any fee/cost incurred from volunteering at the organisation of your choice. ---YesNo What are the main skills that you believe you are good at and that you are able to contribute to the organisation of your choice (max. 3 choices) *: Physically healthy/fitFluent in written and spoken Bahasa MalaysiaFluent in written and spoken EnglishPhotography, Videography and Editing experienceGraphic Design and Visual Communication experienceResearch experienceGood verbal Communication & Public SpeakingIT and/or programming experienceEnvironmental education experienceCompetent with MS Office (Microsoft Word, Excel & Power Point)Social Media savvySales and Marketing experienceCompetent with Adobe Photoshop & IllustratorExperience working with Kids/StudentsAble to teach Do you have any medical or health conditions which may impact your ability to volunteer? Eg. Asthma, Heart Conditions, etc. (Kindly mention any conditions that you may have) Emergency Contact Person — Name & Phone Number (Cannot be self)* Details for Insurance Purposes (Insured - Volunteer) Beneficiary Full Name (Cannot be self) * Beneficiary IC / Passport Number * Beneficiary Contact Number * Beneficiary Home Address * Relation with insured (Example: Mother, Father, Sister, Brother) * Part 3 — Getting To Know You Share with us a moment when you demonstrated leadership. * (max. 50 word count) Please tell us about your proudest achievement. * (max. 50 word count) Do you have any skills, talents or interests (coding, design, drawing, writing, speaking, etc) that you would like to share with us? * (max. 50 word count) Describe your most challenging time in school/university and how did you overcome it * (max. 50 word count) If you could invent a time machine & go back in time or to the future, what would you do? * (max. 50 word count) PDPA Consent Clause By submitting this form, I agree and give my consent to any personal data being collected, stored, retained, retrieved, used, transmitted and processed by Roots & Shoots Malaysia and its member organisations in accordance with its Data Protection Policy, including the disclosure of any personal data to relevant governmental authorities or approved third parties where required by law or for legal purposes.