Contact Information

Birth Date*
Confirm Email*
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Volunteer Information

Midwives For Haiti volunteers are responsible to precept students at low-resource prenatal clinics in remote villages, as well as at birth centers and hospitals, where emergency medications and transportation may not always be available. In some cases babies and women could and do die from those lack of resources. If you feel these situations potentially too overwhelming for you, a trip with Midwives for Haiti is likely NOT for you.*
Desired trip departure date SATURDAYS ONLY (1st choice) **mm/dd/yyyy*
Desired trip departure date SATURDAYS ONLY (2nd choice) *mm/dd/yyy**
Desired trip length*
Previous Midwives For Haiti Experience?*
Professional Credentials*
Training and/or Experience
Advanced Midwifery Skills
Place/Setting of training/experience*
Language Skills
If you have a background in international development, NGO management, curriculum design, data analysis, public health, or other skills that would benefit either the staff at MFH or the programs, please feel free to list these skills.
Other Skills?*
Do you have any experience in a low resource country or a cross-cultural setting? If yes, please describe:*
Please list below any activities or projects that you are interested in leading or participating in:*
Emergency Contact Name (First and Last)*
Emergency Contact 10-digit Phone Number (0000000000 format, no dashes)*
Do you have any dietary preferences?*
T-Shirt Size*
How did you learn about MFH?*
If you were referred by another MFH volunteer, please list their name. If not, please write N/A.*
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