Visitor and Volunteer Application Form

Sections marked with a * must be completed. All details will be treated confidentially.

Details
Do you intend to join Child of Hope as a:  *
 Volunteer
 Visitor
Name as printed on birth certificate/passport:  *
Name if different from above:  *
Address:  *
Postcode/Zip:  *
Country:  *
Contact Telephone Number:  *
Details 2
Your age:  *
Email Address:  *
Do you hold a valid passport?:  *
 Yes
 No
If Yes, expiry date:
Have you ever been convicted of a criminal offence?:  *
 Yes
 No
If yes, please give details regarding the conviction:
Skills
List any qualifications and specific skills you have:
Are you currently employed?:  *
 Yes
 No
If yes in what position?:
What do you see as your strongest character feature?:
What do you see as your weakest character feature?:
Have you taken part in voluntary work before?:  *
 Yes
 No
If yes – with which organisation/what activities were you involved with?:
What are your hopes for your future, and how do you think your time with us will help?:  *
Health Information
Please indicate below any medical conditions:
Do you have any conditions which might affect your ability to fully function as volunteer:
Are you presently under medication prescribed by a doctor?:  *
 Yes
 No
If yes, please give details:
Do you have any specific dietary requirements?:  *
 Yes
 No
If yes, please give details:
Emergency Contacts
Emergency Contact 1 Name:  *
Relationship to you:  *
Address:  *
Postcode/Zip:  *
Contact telephone number (home):  *
Contact telephone number (mobile):  *
Emergency Contact 2 Name:  *
Relationship to you:  *
Address:  *
Postcode:  *
Contact telephone number (home):  *
Contact telephone number (mobile):  *
Travel Experience
Please tell us about any previous travel experience you’ve had:
Have you visited a developing country before?:  *
 Yes
 No
If yes, what did you do there?:
Have you travelled by yourself before?:  *
 Yes
 No
If not, do you think you will be able to cope?:
Are you able to provide us with a reference from someone who knows you well? Perhaps a pastor, university lecturer, work employer – particularly outlining how they feel you would cope with a trip to a developing country.:  *
 Yes
 No
The Trip
Suggested dates of arrival/departure:  *
How long do you intend to work with us, and do you plan to do any other traveling while in Uganda?:  *
How do you plan to fund your trip to us including travel, accommodation, living expenses, etc?:  *
Food requirements:  *
 Western
 Ugandan
 Vegetarian
What are your personal expectations for this visit or voluntary service?:  *
How did you hear about Child of Hope?:  *
What do you hope to gain from the experience of working with us?:  *
More Information:
And finally...
Sign up for our news! You can receive news from Child of Hope in two ways; either by emailed newsletter (approx monthly) and/or by a printed newsletter in the post (once or twice a year). Both are great ways to keep up-to-date.:
 email newsletters
 Printed newsltters
Please check through the form and press submit when completed

 

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