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Contact Us
History Makers UK
28 August - 2 September 2018
Application Form
*
Indicates required field
Name
*
First
Last
Title (e.g. Mr, Mrs)
*
Date of Birth (DD/MM/YY)
*
Gender
*
Male
Female
Nationality
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
*
Mobile Phone Number
*
Email
*
Name of Home Church
*
Marital status
*
If married, spouse's name
*
Number of children, if any
*
Are you employed/studying/in ministry/other?
*
Current position
*
Nature of your job/responsibility
*
Emergency Contact Name
*
First
Last
Only for emergency use
Emergency Contact Number
*
Any health/dietary requirements
*
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).
*
Please write a four-line biography of yourself
*
The total cost of HMUK 2018 is £300 per person.
Once your application is confirmed, a £100 deposit is required to secure your place.
Please give details of two leaders who can provide references for you, one of these should be your church leader.
Name of referee 1
*
First
Last
This should be your church leader.
Position
*
Email
*
Phone Number
*
Mobile Phone Number
*
Name of referee 2
*
First
Last
Position
*
Email
*
Phone Number
*
Mobile Phone Number
*
Use of personal data: We will only use this information to make a decision on your application, and to contact you, or your referees, 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