Ready to make an impact? Please complete the application below to join our upcoming mission.

To avoid system errors, please provide unique contact info for each person; shared emails will prevent your application from processing.

Have you been on a GAiN Mission with GAiN Australia before? *

Yes

Which GAiN Mission would you like to join?

What prompted you to go on a GAiN mission? *

What are your expectations of this mission? *

Are you comfortable participating in a trip organised by a Christian organisation, which may include faith-based activities, such as prayer and community engagement? *

Yes

Is this your legal name? *

Yes

Gender *

Female

Male

Are you a medical professional? *

Yes

What is your primary medical qualification?

Where did you obtain your primary medical qualification, and what year did you graduate?

Are you currently registered with the Australian Health Practitioner Regulation Agency (AHPRA)?

Yes

Please provide your AHPRA registration number.

Upload a current copy of your medical certificate/license

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Referee 1 – Name *

Referee 1 – Phone *

Referee 1 – Email *

Referee 2 – Name *

Referee 2 – Phone *

Referee 2 – Email *

Contact 1 *

Name
Relationship
Phone
Email

Contact 2 *

Name
Relationship
Phone
Email

Do you have any condition/s which may limit you, such as serious allergies requiring medication, depressive/mental illness, limited mobility, extremely poor eyesight, hearing loss, severe asthma, chronic fatigue, food intolerances, etc? *

Yes

Please provide details of your medical conditions.

Are you currently or have you been under a doctor or psychiatrist's care in the past 2 years (apart from minor ailments)? *

Yes

Please provide details of any significant medical care received, including the nature of the condition and the dates of treatment.

Dietary Requirements *

Please list medical requirements only, not preferences.

Yes, I have read and agreed to the privacy policy.

I understand GAiN reserves the right to select applicants for the mission and may exclude applicants on the mission trip if they fail to meet the necessary requirements or values or code of conduct standards.

How did you hear about this?

If other, please tell us more

Mission Application

Personal Details

Contact Details

Referee Details

Emergency Contacts

Medical History