Placement Two: 28th June - 19th July

Friday, 7 June 2024, 00:00 - 23:59

My Details

First Name *

Last Name *

Date Of Birth *

Email *

Phone Number *

Nationality *

My Address

Address Line One *

Address Line Two

Town/City *

County

Eire Code *

Country *

I would like to raise *

Education

Are you currently in full time education? *

Yes No

Employment

Name of Employer *

Dates of Employment *

Role & Responsibilities *

Volunteering

Why do you want to participate in Nurture Africa's volunteer programme? *

In your opinion what attributes should oversea volunteers should have? To what extent do you think you have these attributes? *

If you wish to add any further information to support your application you can do so here

Do you have any medical conditions, disability or history of psychiatric illness that may affect your placement in Uganda? *

Terms

I confirm that I have not been convicted of, nor am I under investigation for, an offense within my personal or professional life which deems me unsuitable for a post which involves volunteering with vulnerable adults and children. I understand my application will be subject to relevant Garda/Police clearance. *

I understand I must attend two programme days in Ireland prior to my placement in Uganda *

I agree to fundraise €1750 (October Programme - 2 weeks), €2300 (Summer 3 weeks - professional), €2500 (Summer 3 weeks - students) for Nurture Africa before my departure to Uganda. *

I hereby declare that I have completed this application myself and my answers are true and accurate to the best of my knowledge *

References

Reference One Name *

Reference One Email Address *

Reference Two Name *

Reference Two Email Address *

EMERGENCY CONTACT DETAILS

Emergency Contact Name *

Their relation to you *

Emergency Contact Phone Number *

Placement Two: 28th June - 19th July

My Details

My Address

Education

Employment

Volunteering

Terms

References

EMERGENCY CONTACT DETAILS

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