Serve With Us I Imprint Hope

INTERN INTEREST FORM

Step 1 of 3

33%

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Marital Status(Required)

Single

Married

Birth Date(Required)

MM slash DD slash YYYY

What motivated you to inquire about interning at Imprint Hope?(Required)

VOLUNTEER SESSIONS

Please select which length of stay interests you.(Required)

Short term intern (2 weeks - 3 months)

Long Term Intern (+3 months)

What time-frame can you intern in Uganda?(Required)

What experience do you have working with children with disabilities?(Required)

Why do you want to become an intern at Imprint Hope?(Required)

What level of education have you completed?(Required)

It is a requirement that interns consent to a Criminal Records Check. Are you willing to participate in this?(Required)

Yes

Do you have a valid passport?(Required)

Yes

Passport expiration date(Required)

MM slash DD slash YYYY

Do you have any allergies? Please explain.(Required)

Do you take any medications that we need to know about?(Required)

Consent

I grant Imprint Hope permission to use my photo on social media and other publications.

EMERGENCY CONTACT INFORMATION

Name(Required)

First Last

Emergency Contact's Relationship to YOU(Required)

Phone (cell)(Required)

Phone (work)

Consent(Required)

By completing this Intern Application / Intake Form, I verify that all information provided is valid, and I understand that my responses to these statements and questions will be used to determine my eligibility to serve as a volunteer at Imprint Hope.

Name

This field is for validation purposes and should be left unchanged.

GROUP INTEREST FORM

Step 1 of 3

33%

Organization Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

GROUP LEADER'S INFORMATION

Name(Required)

First Last

Phone(Required)

Email(Required)

What motivated you to inquire about interning at Imprint Hope?(Required)

GROUP INFORMATION

How many people are in your group?(Required)

Imprint Hope can typically accommodate groups consisting of no more than 10 people.

Age Range of Volunteers(Required)

19-24

25-29

30-39

40-49

50+

VOLUNTEER SESSIONS

These are the dates of intake sessions for mothers and children receiving services at Imprint Hope in 2022. Groups typically arrive and depart on Saturday or Sunday and work Monday-Friday. Each term can be for 1-7 weeks during any of the intake sessions depending on the group's availability and the number of spots available during the intake session.

Please select which session(s) interest you.(Required)

Do the members of your group have any experiences working with children with disabilities? Please explain.(Required)

Why do you believe Imprint Hope would be a good fit for your group?(Required)

It is a requirement that volunteers consent to a Criminal Records Check. Are you willing to participate in this?(Required)

Yes

Are you willing to commit to participating in and completing the volunteer training that will be made available to you when you arrive?(Required)

Yes

Consent(Required)

By completing this Volunteer Application / Intake Form on behalf of my group, I verify that all information provided is valid, and I understand that my responses to these statements and questions will be used to determine our eligibility to serve as a volunteers at Imprint Hope.

Phone

This field is for validation purposes and should be left unchanged.

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imprint your mark in uganada

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imprint your mark in uganda

We are excited that you are interested in serving alongside us in Uganda.

I want to Intern

i'm part of a group

INTERN INTEREST FORM

VOLUNTEER SESSIONS

EMERGENCY CONTACT INFORMATION

GROUP INTEREST FORM

GROUP LEADER'S INFORMATION

GROUP INFORMATION

VOLUNTEER SESSIONS