Volunteer Information

Trip Dates*
  • March 6-14, 2020 (Arrive in BLZ on March 7)
  • July 19-29, 2020 (Arrive in BLZ on July 20th)
  • Other (Please explain below)

Both 2019 Medical Trips are full.

 

The Grounds Fee for the March trip is $1200. The Grounds Fee for the longer July trip is $1400. (More details below.)

Medical Specialties*
  • Veterinary Medicine
  • Prayer
  • Nursing
  • Physician
  • EMT
  • Dental
  • CPR/First Aid
  • Therapy
  • Nurse Practitioner
  • Physician's Assistant
  • Med Team Support
  • Other Skill or Interest - please note in comment field at end of form
If so, what degree program?
Year of expected graduation?

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
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Email*
Confirm Email*
Mobile Phone*

Travel Information

All trip participants are required to have medical insurance coverage in Malawi. If your health insurance does not provide coverage outside the US, you are responsible to obtain appropriate traveler medical insurance prior to your trip.

Health Insurance Provider*
Health Insurance ID*
Name on Passport*
Passport #*
Passport Expiration Date*
Country of Citizenship*

Trip Payment Information

Unless other arrangements apply, please pay a $500 deposit as soon as possible to reserve your place on the trip.

The grounds fees total of either $1,200 (for March) or $1,400 (for July) includes the $500 deposit.

*This amount covers expenses while on the ground in Malawi, but does NOT include airfare or insurance.*

Trip Payment*
  • I will mail a check to VIP.
  • I will pay online with a credit card.
Additional Comments

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