#CHANGE - GREECE 2019 Application Form
Please complete this application form to apply to take part in the #CHANGE trip to Greece on 27th October to 3rd November 2019. If you are selected you will need to raise £360 which can be paid in monthly instalments of £60 over 6 months, starting on 15th April
First Name *
Your answer
Surname
Your answer
Preferred pronoun?
Email *
Your answer
Address *
Your answer
Phone number
Your answer
Will you be able to take part in a 10 week training course prior to the trip?
If no, please explain why
Your answer
Why would you like to take part in this trip? We want to know how it can make a difference in your life and how committed you will be
Your answer
Would you consider yourself to have a disability? If yes, please explain
Your answer
Do you have any medical needs, including mental health? If yes, please explain
Your answer
What is your level of swimming ability?
Do you have a passport? (if not you will need to raise an extra £100)
Emergency contact name & relationship to you
Your answer
Emergency contact telephone number
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Esteem. Report Abuse - Terms of Service