Online Application Form

PERSONAL INFORMATION

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CHURCH DETAILS

 
 

MARITAL STATUS

Dependents

 

EMERGENCY INFORMATION

In case of an emergency, contact:

 

PASSPORT INFORMATION


Personal History/Health Form

Please answer ALL questions and explain any “YES” answers in the space below.

Are you now under doctor’s care for any condition?

Are you taking any medication at this time?

Do you have any physical handicaps or health conditions, which require special attention?

Do you have a history of emotional instability or psychiatric treatment?

 

Immuniztion

Because of the nature of mission work, there is a high risk of exposure to communicable diseases. NOT FORGOTTEN DOES NOT TAKE RESPONSIBILITY FOR ANYONE WHO GETS CONTAMINATED BY THE BLOOD OR BODY FLUIDS OF ANOTHER PERSON AND THEREBY CONTRACTS HIV, HEPATITIS, OR ANY OTHER COMMUNICABLE DISEASE. Not Forgotten strongly advises each prospect to ensure that the following IMMUNIZATIONS are received BEFORE coming to volunteer with us.

  • Injectable or oral Polio Vaccine
  • Tetanus Toxoid injecHon was 5 years ago
  • Hepatitis A vaccine X3 injecHons
  • Hepatitis B vaccine X3 injecHons
  • Meningitis vaccine

  Malaria: You will not need malaria prophylaxis during your time at Not Forgotten.

Consent for Treatment


LIFE QUESTIONS

A. Spiritual Life

   B.   Church Life (Type n/a if you do not attend church) 

C. Personal Life

D. Other


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