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Contact Us
History Makers UK
11-13 March 2022
and
6-8 May 2022
Application Form
PERSONAL DETAILS
*
Indicates required field
Name
*
First
Last
Title (e.g. Mr, Mrs)
*
Gender
*
Male
Female
Date of Birth (DD/MM/YY)
*
Mobile Phone Number
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Are you employed/studying/in ministry/other?
*
Any health/dietary requirements
*
Name of Home Church
*
Emergency Contact Name
*
First
Last
Only for emergency use
Emergency Contact Number
*
1.
Have you previously attended a History Makers Online course?
*
Yes
No
If you answered 'Yes', please go to
section 4
If you answered 'No', please go to
section 2
2.
Testimony - please share your Christian journey including any significant points in your spiritual journey. (Please use less than 200 words).
*
Why would you like to attend History Makers and what do you expect to gain from taking part? (One paragraph only please).
*
3.
Please give details of your church leader who can provide a reference for you.
Name of church leader
*
First
Last
This should be your church leader.
Phone Number
*
Email
*
Mobile Phone Number
*
4.
Once your application is confirmed, a £50 deposit is required to secure your place. The remaining balance will then be due by 14 February 2022.
Use of personal data: We will only use this information to make a decision on your application, and to contact you, or your referee, with regard to HM UK. We will not share your personal data outside of K180 and the HM UK leadership team without your consent. See our
Privacy Notice
for more information.
Submit