Volunteer Form Please fill in the form below, be honest and accurate. Once this form has been reviewed you will be contacted. Name * First Name Last Name Email * Phone * (###) ### #### Short term or long term volunteer * Short term Long term Country interested in volunteering? South Africa Uganda Date of Birth MM DD YYYY Passport Number * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Criminal Record Yes No How did you hear about short term volunteer teams with The Hope of Africa? Employment Information Position Employer Supervisor Phone (###) ### #### Education Information What level of education have you completed? High School College/University Bible College Other Name of School Year graduated Degrees / Diplomas / Certifications Project Information Project you wish to go on Check all that you are interested and available for. Medical/Dental Mission Construction T rip Gardening/ Agriculture T rip Business Strategies T raining T rip Educator Training/Student Tutoring Trip Youth Leadership Retreat Children’s Day Camps Is there another applicant you would prefer to share accommodations with? Other gifts and abilities (give details) that you could bring to the team: Christian Faith Experience What is your experience of Christian conversion/faith? Describe your faith walk. ie. personal prayer and devotional time. Are you an active member of a church? Yes No Name of church Pastor Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Will the pastor be your pastoral reference? Yes No Finances It will be necessary to pay for or raise your own support for your service with The Hope of Africa (approx. $3500 US). Are you willing to do this? Yes No Health How is you health and physical condition: Excellent Very Good Good Limitations Are you taking any prescription drugs? Yes No If Yes, please describe. Physician Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country In case of an emergency, please notify: Name Relationship Phone (###) ### #### Volunteer Work Please tell us about your volunteer activities (church, community, charity organizations, etc.) Previous Missions Trip Please tell us about any other missions trips you’ve been on: i.e Date, role, organisation and locaton. References. One personal, one pastoral, one professional - supervisor or volunteer supervisor Personal -Name First Name Last Name Email Phone (###) ### #### Pastoral - Name First Name Last Name Email Phone (###) ### #### Supervisor - Name First Name Last Name Email Phone (###) ### #### Thank you!
