Form

First Name:*

Last Name:*

Date of Birth:*

Month Day Year

Age (Must be at least 18)*

Gender*

Primary E-mail*

Primary Phone:*

- Area Code Phone Number

Secondary E-mail

Secondary Phone:

- Area Code Phone Number

Street Address 1:*

Street Address 2:

City:*

State:*

Zip code:*

Country:*

Have you ever traveled outside of the continental United States?*

If yes, where and for how long? (list as many as you like)

Do you have any previous volunteer experience?*

If yes, please briefly describe:

Which Trip are you interested in joining?*

How did you hear about The UAPO?*

Why do you want to travel to Uganda?*

Do you have any health problems/issues that need frequent medical attention?*

If yes, please explain:

Which of UAPO's projects are you interested in and why?*

What, if any, are your expectations for serving in Uganda? What do you hope to accomplish?*

Are you willing to work and participate on trip as a team, following all rules and guidelines mandated by The UAPO?*

Are you comfortable living and working in a Christian environment, even if it is different than what you are accustomed to?*

Do you understand that participation in The UAPO volunteer program is at your own risk and that you will be required to sign a liability release form?*

Are you willing to pay for your expenses either through fundraising or other avenues including airfare, insurance, vaccinations and general living expenses for the entire duration of your trip?*

Do you have a valid passport that expires more than 6 months after your return from Uganda? If not, you will need to renew your passport to be eligible for the trip.*

Contact Information:

Travel & Volunteer Experience:

Questionairre: