Volunteer Travel Application

Name

First NameLast Name

Phone Number

Country CodeArea CodePhone Number

Email

example@example.com

Family Member Volunteer Names

We welcome spouses and children 12 and up as general volunteers. If you would like family members to accompany you on the mission, please provide their names above.

Please review our upcoming mission dates and the roles needed below.

Which date(s) are you applying for?

Use this format: MM/DD/YYYY - MM/DD/YYYY

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please select the Volunteer Role that best describes you:

Surgeon Specialty

Emergency Contact

First NameLast Name

Emergency Contact Phone

Country CodeArea CodePhone Number

Emergency Contact Email

example@example.com

Dietary Needs / Allergies

Enter "none" if you have no special dietary needs / allergies

Have you been part of an ACE Global Teaching Travel Team before?

Will you need a Volunteer Expense Acknowledgment Letter?

Please fill out and upload the following with as much detail as possible.

Medical Credentials/Licensing

Please upload all current applicable medical credentials and/or licensing (copy of License and copy of Diploma)

No medical credentials or licensing

Passport

Please upload a photo of your valid passport. If you will accompanied by any family members, please also upload a photo of their passports. If your passport is not valid at this time, please take the opportunity to renew/apply for one as it will be required for travel.

Experience & Qualifications

Please give a brief explanation of your professional experience and qualifications to take on this volunteer role. If you are a surgeon, please give a breakdown of types of cases you handle in your home practice.

Personal Statement

Please give a brief statement of why you are applying to volunteer with ACE Global. What do you hope to give and/or gain through the experience?

Do you have past medical mission or humanitarian aid experience?

Please explain any experience you may have working/volunteering outside your home practice that may apply.

Do you speak another language other than English, how fluently?

Anything else you would like us to know and/or consider?