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Personal Information

Select Month *

Title *

First Name *

Last Name *

Date of Birth *

Email Address *

Mobile Number *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Employment

Employment Status *

What is your job title? *

Disclosure

Convictions *Mercy to Humanity prioritises the safety of both their volunteers and the vulnerable people that we work with. It is for this reason that all of our volunteers and applicants are exempt from the Rehabilitation of Offenders Act 1974. This means that any criminal convictions you have had in the past will need to be declared including any convictions categorised “unspent” under the above legislation. Yes/No. If yes please give details of offence and date.

Provide detail *

DBS *Do you consent to having a full DBS (Disclosure and Barring Service) check done? Yes/No

Medical Conditions *Do you have any medical conditions that may affect your health during the deployment? It is important that we are aware so we can provide you with any assistance you may need. Yes/No. If yes please give details.

Provide detail *

Previous Experience

Previous deployment experienceHave you ever been on a deployment trip before? Yes/no. If yes please give details.

Keeping up to date with mercy to humanity

How did you hear about our deployment programme? *

Keeping you informed *Text (SMS)E-mailI would like to receive updates about Mercy to Humanity. This may include information about any upcoming trips, events and general news. Emergency appeals will also be sent out. I am happy to be contacted via

Personal Information

Terms and conditions

Terms and Conditions *I agree to these terms and conditionsI declare that the information given in this form is correct and complete.

I must have a valid passport with six months before expiry.

I give permission for my personal details, including the information contained within this form, to be used for the purpose of progressing my application.

I understand that submitting my application does not confirm my attendance on a trip, however it does allow Mercy to Humanity to assist me with my booking.

My behaviour and mannerisms must mirror the charity’s values and I will ensure that I follow the procedures outlined in the documents that will be provided to me.

I understand that my application may be denied if I do not meet the criteria needed to attend this deployment. I understand that Mercy to Humanity reserves the right to postpone any deployment if required.

Unit 16, Skylines Business Village, London, E14 9TS

1 Clarence Terrace, Dewsbury, WF12 9JZ

07864 965 865
07864 965 865
deployments@mercytohumanity.org.uk

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