application form
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The TCM-Social forum is looking for acupuncturists and TCM practioners who are motivated, open-minded, mature, and who express sensitivity, compassion, and respect toward others. Volunteers requires flexibility and commitment. The description of the procedures of application and the principles of TCM Social forum should be read by applicants before filling out the application.

(first)                    (last)


Date of birth_____/_____/______

Telephone #_______________________  Email_____________________

Telephone #______________________    skype name________________________

TCM, Acupuncture o.Qi Gong Education: ______________________________


Place of Licensure: ____________________________________________________

Acupuncture Experience: ___________________________________________________


Clinical Experience with HIV/AIDS o.o. infectious disease: _______________________


How did you hear about the TCM Social forum?______________________

Required application materials:

1. Completed application form
2. Written statement of purpose (why do you want to participate the TCM Social forum?)
3. Two letters of recommendation (for PAAP three): at least one of these letters must be from individuals who have worked with the applicant in a professional capacity. Only one letter may be a personal reference. No letters may be submitted by family members or by individuals with whom the applicant has had a patient/practitioner relationship.
4. Certificates of education
Consent declaration

I am a fully trained therapist and have permission to practice or teaching of Chinese medicine. I know the risks and hazards during my volunteer work and carry full responsibility for it.

I have read the principles of TCM Social Forum and agree to them.

I aware that it is always possible in the projects to unforeseen circumstances, and I will adjust flexibly. I'll discuss everything concerning to the project subject to the project coordinator or the head of the TCM Social Forum.

I will not create any needs and withhold my private needs in front of the local population.

I know that our help is mostly not materially and will not provide financial support without consultation. Any request for financial support do I forward to the organizers.

I waive any compensation, regardless of legal grounds. Unless the association, its board or an active agent in his behalf is guilty of willful or grossly negligent conduct.


Name, date and signature



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Donation account TCM-Sozialforum
Berliner Sparkasse
IBAN DE 100 500 00 660 410 0 810


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Next Donation Week

23th to 29th May 2016



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