Apply for a borehole construction FILL IN THE FORM BELOW TO SUCCESSFULLY GET A BOREHOLE BUILT IN YOUR AREA DETAILS ABOUT THE AREA REQUESTING THE BOREHOLE Water source will be under which ownership? ---PrivateCommunalInstitutional Is there electricity near the proposed site for water source? ---YesNo Select the source of water people use currently ---BoreholeDug WellSpringSurface WaterLake/RiverSwampTap WaterOthers State the Proposed use of water ---Domestic UseLivestockIrrigationOthers Are there existing boreholes within one (1) kilometer to proposed the site? ---YesNo If yes. How many? DECLARATION I certify that the information provided in this form is correct to the best of my knowledge. I also agree that no decision will be made pursuant to this application until I receive a notification from the Management of Hands on Foundation Uganda. IMPORTANT NOTE All applications will be evaluated and Hands On Foundation Uganda shall communicate to only successful applicants.