Application for Training and Support from MAITS

Name of Organisation: *

Details of person completing the application on behalf of organisation

Surname (BLOCK CAPITALS): *

Forenames: *

Title: *

Contact Details

Address: *

Telephone Number: *

Email Address: *

Organisation website:

Please provide a description of your organisation, including information on the following:

Mission statement or objectives of the organisation:

General information about the individuals you support - age range / range of special needs:

Services / programmes provided (including funding source):

Current organisation development plans:

Current staff training programme, if any:

Numbers of and range of experience and levels of staff:

Please outline the areas in which your organisation would like training and support from MAITS Visiting Overseas Professionals (VOPs):

Please give the names and addresses of two referees who can verify the aims of your organisation

First Referee

Name: *

Address: *

Telephone Number: *

Email Address: *

Second Referee

Name: *

Address: *

Telephone Number: *

Email Address: *

Please give any other relevant information you wish to provide, e.g. special requirements for volunteers, such as Male Only, etc:

Please click Yes below to confirm that you have completed this application to the best of your knowledge.

Confirm: *

Yes