Africa Trust Application Form

Full Name

Date of Birth

Name & Address of School or University

Home or Other Contact Address

Contact Telephone

Qualifications:

Key Points:

Are you a capable swimmer?

Yes

No

Do you have a full UK driving licence?

Yes

No

Nationality:

Passport Number:

Date of Issue

Place of Issue

Are you a smoker?

Yes

No

Vegetarian?

Yes

No

Vegan?

Yes

No

Current Height:

Current Weight:

Illness or Accidents:

Allergies or Phobias?

Yes

No

If YES, please describe:

WHEN YOU HAVE COMPLETED THIS FORM YOU SHOULD:

1 - Check you have actually completed all the answers.
2 - Click the Submit button

NB: Successful applicants who are called to a UK interview will need to bring a passport size photograph, the registration fee of £30 and a letter of reference supporting the contents of this application form.