Centennial Trip Additional Info Form

Abayudaya Centennial Trip Additional Info Form

We are delighted that you will be joining us in Uganda this summer! Please provide the additional information below.

Name *

First

Last

Home address *

Address Line 1

Address Line 2

City

State

Zip Code

Mobile number *

Mobile number while in Uganda (if different from above)

Bio *

Please share a little bit about yourself for the trip orientation materials.

Headshot *

Click or drag a file to this area to upload.

Please upload a headshot of yourself for the trip orientation materials.

Inbound flight arrival date/time *

Inbound flight number *

Outbound flight departure date/time *

Outbound flight number *

Passport *

Click or drag a file to this area to upload.

Please upload a scan of the first page of your passport to facilitate travel and hotel arrangements.

Name *

First

Last

Relationship *

Phone *

Email *

Comment

Please send us a message or call 415.386.2604.