Journey to Uganda Application

Name*
First Last
Email Address*
Enter Email Confirm Email
Mobile Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
What is your inspiration for going on this trip?*
Have you traveled to the developing world before?
Do you understand the context and feel comfortable traveling to a country with limited infrastructure and different cultural sensibilities?*
Do you have any questions and/or concerns about traveling to Uganda?*
Do you have any special physical or dietary needs that we need to know about?*
What do you believe you can contribute to our travel group?*
Are you interested in bringing a friend, family member, or additional guest(s) who are 13 years or older?*
Do you understand and agree that you are responsible for making your own travel arrangements to Uganda, and that your deposit is non-refundable and becomes a donation to Just Like My Child Foundation if you cancel your plans? If so, please check below:*
- I agree.
Nationality*
Dates of Visit*
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