in His hands
 Community Focus 

Uganda 2010 - Expression of Interest

Great, you are looking to join us in serving the people of Uganda. Please complete the following information so that we can record your interest and look to work with you to turn the expression into reality.

 

Name:

Address:
 
 
Town:
County:
Postcode:
Country:

 

Email Address:

 

Date of Birth*: DD  / MM  / Year 

* If you are under the age of 18, your application will not be considered without your parents having first completed a consent form.

 

Brookside Church Member?

If No, please enter the name and address of the church you attend
Church details

Skills

Please details what skills or professional qualifications you believe that you would bring to the team.

 

Known medical conditions?

It is imprtant to advise us if you suffer from any medical conidtion which could put you at risk in travelling to Uganda where medical facilities are limited. Do you suffer from any medical condition?

 

Yes/  No

 

If Yes, please describe your medical condition
Medical Details

 

Special Dietary Requirements 
Do you have any dietary requirements that could be difficult to fulfil?
Yes/  No
Dietary Details
 

Thank you completing this form. A member of the Brookside Leadership Team will be in contact with you shortly to discuss your expression of interest in travelling to Uganda in 2010.

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