Name - First & Last
Age
Sex
Mailing Address (Street, City, State, ZIP)
Your Email
Phone Number
Religious/Spiritual Affiliation
Will you have any dietary needs? If yes, explain.
Will you have any allergies? If yes, explain.
Emergency Contact Name
Relation to you
Emergency Phone Number
Major
Have you ever traveled out of the country? If yes, where?
What would you hope to gain from this experience?
It is our goal to provide experiences for all volunteers that will further their professional/personal life goals. Please share how trip leadership and Haitian staff could help you reach these goals.
Enter The Code Below:
Comments are closed.