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Join Us on One of Our Mission Trips to Ghana
*
Indicates required field
Please list any allergies and any health issues we should be aware of.
*
Volunteer Application
Name
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First
Last
Date of Birth
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Mobile Phone Number
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Email
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Occupation/Profession
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Best Way to Contact
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text
email
phone
Which dates are you applying for?
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Future Healthcare/Education Trip
2021 Service trip
What program are you applying for?
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Mobile Healthcare Clinic
Community Development/Educational Program
Both
What position are you interested in?
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Medical Provider
Dental Provider
Nurse
OT/PT
Other Health Professional (Please specify in comments)
Children's Program
General Helper
Girls Health/Reproduction/Safety Education
Boys Gender Equality Forum
Dementia Awareness/Sensitivity Training
Sports/coaching
Disabilities
Other interest or skill (specify below)
Comments (Please include your experience and skills)
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Please explain what position you would like and what skills, experience or interest you feel qualify you for that position. List any degrees or certifications you may have.
Have you been on a trip with us before?
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yes
no
I have been on mission trips with another organization
Explain previous mission trip experience, if any
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Do you have a valid passport?
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yes, it is valid 6 mos beyond the trip date
no, but will get one if accepted
Have you ever been convicted of a crime? If yes, describe fully below. (A conviction will not necessarily be a bar to participation.)
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yes (describe fully below)
no
Describe
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If convicted of a crime please describe fully in this box.
If accepted, will your participation as a volunteer be contingent on the acceptance of another person?
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yes
no
If yes, what is the name of that person?
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Name of team member you would like to share accommodations with during the mission if possible:
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T-Shirt size (choose one)
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S
M
L
XL
XXL
These are men's size t-shirts
Please list any food preferences or restrictions:
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Is there any other information we should know about? Please tell us why you would like to be included in this mission trip.
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Agreement and Policy: It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disability. By submitting this application, you affirm that the facts set forth in it are true and complete. You understand that if you are accepted as a volunteer, any false statements, omissions, or other misrepresentations made by you on this application may result in your immediate dismissal.
*
Type your signature
Please note: A $250 non-refundable deposit is due to hold a spot on the team once we contact you. It will be refunded if you are not accepted for the trip.
Submit
HOME
Trip Details
Donate
IRS 501 (c) 3
STORE
Products designed with Special needs in mind
>
Bibs
Media Coverage
Video
Gallery
Testimonials
African Black Soap
Contact Us
Events