Short Term Application Form

Full Names

First and Last names (as it appears on your passport).

Date of Birth

Nationality

By Passport.

Passport Number

Residential Address

Country of permanent residence

Telephone

Email Address

Marital Status.

Next of Kin (Spouse etc)

Travelling together with kids or spouse?

Expected date of arrival in Zambia *

Expected date of departure *

Countries you have been in the last five years (and dates)

Highest Level of Education attained

Skills and Professional qualifications

Previous Work or relevant Experience

Have you stayed or applied for a permit in Zambia before? If Yes please give details.

Have you been restricted in entering any country or deported or repatriated from any country? If Yes, please give details.

All Volunteers must enter the country on a business Visa. Do you have one?

Financial Responsibility: I am aware that YWAM is not responsible for my visa fees, medical bills or any expense incurred before, during or after my trip and stay. I am fully responsible for the costs of this trip.

Do you have a medical insurance to cover you during your stay in Zambia??

I understand that I will only travel to YWAM Lusaka once this form has been approved and a confirmation sent to me.

Reference 01: Name and contact of Local Church Pastor or Team Leader.

Reference 02: Name and contact of previous employer.