Palestine Experience 2017 – application form
Sunday 30th July to Tuesday 8th August 2017

Please complete all sections of this form and remember that each applicant needs to complete it. We will contact you by Friday 28th April 2017 to let you know if you have been selected to join the trip. If your application is successful, we ask you to book your own flights and then pay Amos Trust £550 to cover your costs while in Palestine.

Your personal details
Family name (surname) *
As per your passport
Your answer
First name *
As per your passport
Your answer
Middle name(s)
Leave blank if none
Your answer
Gender *
Title *
Passport issuing country *
As per your passport
Your answer
Passport number *
As per your passport
Your answer
Nationality *
As per your passport
Your answer
Date of birth *
MM
/
DD
/
YYYY
Passport issue date *
MM
/
DD
/
YYYY
Passport expiry date *
Your passport must be valid for at least 6 months from 30 July 2017
MM
/
DD
/
YYYY
Passport stamps *
Please list all the stamps in your passport
Your answer
Your contact details
email address *
Your answer
Contact phone number *
(UK mobile preferred) (format xxxxx xxxxxx)
Your answer
Home address *
Your answer
Skills
Your skills *
Please outline any specific skills or experience you have in the following areas: Digital media (particularly film making and editing), dance (particularly contemporary and street dance), music (particularly singing and singing teaching), Arabic (speaking and/or translation), youth work, creative workshop facilitation, First Aid. Please indicate whether you work professionally in these areas.
Your answer
Other information
Visiting Palestine
Have you been to Palestine before and, if so, when did you visit and what did you do?
Your answer
This trip
How did you hear about this Amos trip?
Your answer
Your health
Please let us know about on-going health or mobility issues that the trip leaders should be aware of.
Your answer
Now please press "Submit" to send us your form
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