Brigade Application

  • Brigade Application

  • Adult Status*
  • DOB*
     - -
  • Format: (000) 000-0000.
  • Gender
  • Are you willing to come to Honduras early, July 18, to pack medicines before the brigade?*

  • Emergency Contact Information

    A person not on the trip
  • Format: (000) 000-0000.

  • Travel / Passport Information

  • Have a passport?*
  • Expiration Date
     - -
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  • Travel Insurance

    This will be purchased by HGW for you
  • Format: (000) 000-0000.

  • Frequent Flyer / Rewards Program

  • Our flight to Honduras on United Airlines leaves from IAH airport July 22, at 9:30am. You will need to be at the group check in counter by 6:30 AM. On the return leg our flight arrives to IAH at 4:40 PM. Do you want to reserve a room at the Houston Airport Marriott before or after the trip? This will be at your own expense at a group rate of $179/night.
  • What day?
  • Are you interested in sharing a ride to Houston?
  • Do you need help with arrangements flying into Houston (IAH)?

  • Work Team Preferences

  • PHYSICIANS
    We must have a copy of your medical school diploma and current license to practice. We keep the diplomas from year to year so if you have traveled with us before we should have it on file. Send copies of your diploma and current license to brigade.info@hondurasgoodworks.org.

  • If you are a medical provider will you need a translator?

  • Everyone, including providers,  please be aware that you will be required to assist with the repacking of meds at night, and may be required to work in the pharmacy as part of your duties. Other duties may also be assigned as needed.

  • Work Team Preference
  • Can you be a translator for a medical provider, nurse or pharmacy?*
  • Play an instrument or sing?*

  • Team Safety

    We rent 4WD manual pickups to get around. You must be at least 21 to drive.
  • Are you willing to drive in Honduras? You must be able to drive manual pick up trucks with 4 wheel drive over potentially challenging roads.*
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  • Driven for HGW in the past?
  • Have you attended Safeguarding God's People?
  • Have you attended Safeguarding God's Children?
  • Have you attended other Youth Protection Training, such as Scouts?

  • Consent and Release for Background Check

  • Format: 000-00-0000.

  • I hereby authorize Castle Branch, Inc. and Honduras Good Works to request and receive any and all background information about or concerning me, including but not limited to my Criminal History including a consumer report under the Fair Credit Re- porting Act, 15 U.S.C. 1681, Driving Record, Employment History, Military Background, Civil Listings, Educational Background, Professional License from any Individual Corporation, Partnership, Law Enforcement Agency, and other entities including my Present and Past Employers.

    The criminal history, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications and delinquent conduct as committed as a juvenile. I understand that this information will be used, in part, to determine my eligibility for an employment/volunteer position with this organization. I also understand that as long as I remain an employee or volunteer here, the criminal history check may be repeated at any time. I understand that I will have an opportunity to review the criminal history as received by client/agency and a procedure is available for clarification, if I dispute the record as received. I also understand that the criminal history could contain information presumed to be expunged.

    I further release and discharge Castle Branch, Inc. and Honduras Good Works and all of their Subsidiaries, Affiliates, Officers, Employees, Contract Personnel, or Associates, from any and all claims and liability arising out of any request for information or records pursuant to this authorization, procurement of an investigative consumer report and understand that it may contain information about my character, general reputation, personal characteristics, and mode of living, whichever are applicable.

    I understand that I have the right to make written request within a reasonable period of time tor additional information concern- ing the nature and scope of the investigation. I acknowledge that I have voluntarily provided the above information for employ- ment/volunteer purposes, and I have carefully read and understand this authorization.

  • IGNORE THIS PAGE FOR MINORS!

  • Code of Conduct

  • Consent, Liability Release and Indemnification

  • Photo Release

  • Photo Release Agreement*
  • Date
     - -
  • I agree to receive all official communication about the brigade by electronic communication: email and text.
  • Should be Empty: