Volunteer Application

Instructions:

Complete our online volunteer application, below. Please fill in all of the mandatory information fields, marked by an asterik (*). Any missing information may delay your application process.
If you are applying for the Medical Internship Program, you are also required to upload your résumé or CV, which you can do at the bottom of this application. Your résumé or CV is optional for all other programs.
Once your application has been submitted, you will be immediately directed to our payment page. The application fee is US$100.00, which will be applied to your placement fee.
Once we have received your application and application fee, we will begin to process your application. We will be in touch as soon as we have put together the details for your specific placement, and send you a placement outline that you can then look through. If the initial outline is not specifically what you had in mind, please let us know and we will make the necessary changes, before you deposit the remaining placement costs.

Last Name:*

First and Middle Name:*

Date of Birth:*

Nationality:*

Gender:*

Full Name:*

Relationship:*

Phone:*

Email:*

Preferred Program:

Please tell us a little bit about yourself, why you want to volunteer and what education, skills and experiences you have. *

Start Date:*

End Date:*

Referred By:*

Other:*

File: *(Required only for the Medical Internship Program.)

File size may not exceed 5 MB, and must be in either .doc or .pdf format.

Security Form:*