#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
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First Name   *
Surname
Preferred pronoun?
Clear selection
Email *
Address *
Phone number
Will you be able to take part in a 10 week training course prior to the trip?
Clear selection
If no, please explain why
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
Would you consider yourself to have a disability? If yes, please explain
Do you have any medical needs, including mental health? If yes, please explain
What is your level of swimming ability?
Clear selection
Do you have a passport? (if not you will need to raise an extra £100)
Clear selection
Emergency contact name & relationship to you
Emergency contact telephone number
Submit
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