Family Ministries YWAM Canberra

YWAM SHORT-TERM MISSION – UGANDA

September - October (exact dates to be confirmed)

APPLICATION FORM

If you believe that you should go on this mission please complete the following and send to:

Family Resource Centre Canberra YWAM

PO Box 586, Gungahlin, ACT, 2912

Tel: 02 6242 9928, Fax: 02 6242 9935

Website: www.frccywam.com (for further information)

Surname _________________________Title_____Given names__________________________

Address:__________________________________________________________Post Code_______

Phone: (Home)__________________(Business)_________________(Mobile)________________

Email:__________________________ Fax:______________________

Date of birth_________________Marital status________________Gender (circle): Male Female

Current occupation__________________________________Position_________________________

Name of church and your position______________________________________________________

Name of pastor_____________________ telephone_________________ email_________________

Emergency contact person and phone number_____________________________________________

Name of spouse____________________Names of children_________________________________

Education _______________________________________________________________________

Please describe any ministry courses/seminars, and missionary experience you have completed________

_______________________________________________________________________________

Describe the state of your current health_________________________________________________

Do you have any special food needs (this will be your responsibility)?___________________________

What do you believe are your giftings?__________________________________________________

Any other important information that we need to know about you and your suitability to go on a 2-3 week

outreach in a poor developing tropical country? (use reverse side if necessary)____________________

_______________________________________________________________________________

Explain why you want to go to Uganda (use reverse side of form)

I have enclosed the non-refundable registration fee ($50) (required before processing) (Yes)

Credit card (circle): MC VISA. Name on card___________________________Number_____________________

Expiry date___________ Signature__________________ _____________Date__________________

Signature of applicant__________________________________________Date_________________