After you submit this form, you must submit a $250 non-refundable deposit.

A Kenyan Special Pass is similar to a temporary work permit and required by the Kenyan Government for all team membersThe special pass process has changed a few times, so we will provide you with the necessary forms after you apply for your team. 

Personal Information
Name *
Name
Maiden Name
Maiden Name
Address *
Address
Phone *
Phone
Please list the number we should call to reach you.
Date of Birth *
Date of Birth
Please list N/A if you do not use Twitter. You can follow Open Arms International @OpenArmsIntl
Please list N/A if you do not use Instagram. You can follow Open Arms International @OpenArmsInternational
Medical History
Do you have a history of any of the following *
Check All the Apply
Please list all allergies and separate with a comma. (Fill in N/A if not applicable)
Please list all medication and separate with a comma. (fill in N/A if not applicable.)
Gluten Free, Vegan, etc. Fill in N/A in not applicable. Please separate with a comma
Emergency Contact
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Please check any Relevant Experience
Please Provide Three (3) Character References
References cannot be related
Reference Name (1) *
Reference Name (1)
Reference Phone (1) *
Reference Phone (1)
Second Reference
Reference Name (2) *
Reference Name (2)
Reference Phone (2) *
Reference Phone (2)
Third Reference
Reference Name (3) *
Reference Name (3)
Reference Phone (3) *
Reference Phone (3)
Criminal History
Disclosure
Open Arms International may perform, at its discretion, a background check on individuals who apply for participation on an overseas team. By submitting this application, I approve of Open Arms International performing a criminal background check. I also confirm that the information given above is correct and complete.